Histoacryl blue versus sutured left colonic anastomosis: experimental study

Cyanoacrylates have been advocated as a protective seal in colonic anastomosis to prevent leakage. In order to assess the effects of n-butyl-2-cyanoacrylate on left colonic anastomosis it was compared to the sutured anastomosis in the rat.

Forty male Wistar albino rats were divided into two groups of 20 each. On days 3 and 7, 10 animals in each group were killed. The comparisons between n-butyl-2-cyanoacrylate and sutured groups were made with respect to outcome measures including anastomotic leakage, anastomotic stricture, peritonitis and wound infections, and adhesion formation, anastomotic bursting pressure, histological appearance of the anastomotic area.

Although the adhesion formation was significantly more extensive in the n-butyl-2-cyanoacrylate group on day 3 (P < 0.001), there was no significant difference between the groups on day 7. The more inflammatory reaction also occurred in the n-butyl-2-cyanoacrylate group. The mean +/- SD anastomotic bursting pressure was significantly higher in the suture group than in the n-butyl-2-cyanoacrylate group (63 +/- 14 mmHg vs 43 +/- 8 mmHg) on day 3. The bursting pressure was also found to be higher on day 7 in the suture group (187 +/- 26 mmHg vs 49 +/- 12 mmHg, P < 0.0001). The suture group had a significantly higher bursting pressure on day 7 compared to day 3 (P < 0.05).

Left colonic anastomosis with n-butyl-2-cyanoacrylate in rats does not improve the healing process; on the contrary, it has a negative influence during the first week. As a consequence, the routine use of n-butyl-2-cyanoacrylate in colonic anastomosis in the clinical situation does not appear to be justifiable.