Cyanoacrylate-assisted arterial anastomosis in rat small bowel transplantation

Microarterial anastomosis in rat small bowel transplantation (SBTx) remains technically difficult and time-consuming especially for beginners of microsurgery. In the exploration of the facilitated microarterial anastomosis strategies, we assessed the performance of n-butyl-cyanoacrylate-assisted suture technique (CAST) in comparison with simple continuous suture technique (SCST).

Allogeneic small bowel transplantation was performed in a rat combination of F344 to Lewis. CAST and SCST were used for anastomosis of graft superior mesenteric artery to recipient infrarenal aorta. Success rate of anastomosis, anastomosis time, anastomotic bleeding, and stenosis as well as tissue reactivity of suture materials and their influence on allograft rejection were compared between the two techniques.

CAST significantly reduced anastomosis time and anastomotic bleeding, although its success rate was similar to SCST. Moreover, CAST created regularly shaped anastomotic orifice and smooth luminal surface along the anastomotic line, and provided higher blood flow of graft superior mesenteric artery. The use of n-butyl-cyanoacrylate caused moderate to mild tissue reaction that was comparable to nylon suture; and it did not significantly influence allograft rejection.

CAST is a simple, effective, and safe surgical technique for microarterial anastomosis in rat SBTx. It deserves the interest in exploration of facilitated microarterial anastomosis strategies in animal experiments as well as in clinical settings.