Cyanoacrylate in Colorectal Surgery: Is It Safe?

Area of Science:

• Colorectal Surgery
• Surgical Innovation
• Gastrointestinal Oncology

Background:

• Anastomotic leakage (AL) remains a significant complication in gastrointestinal (GI) surgery.
• Cyanoacrylate (CA) has been explored for AL prophylaxis in colorectal surgery, but human evidence is limited.

Purpose of the Study:

• To evaluate the safety of using CA to seal colorectal anastomoses in human patients.
• To assess the incidence of AL and adverse reactions associated with CA sealant.

Main Methods:

• Retrospective analysis of 103 consecutive patients undergoing minimally invasive colorectal surgery from January 2022 to December 2022.
• Inclusion criteria: histological cancer diagnosis, totally minimally invasive procedure, no intraoperative complications.
• N-butyl cyanoacrylate with metacryloxisulfolane (Glubran 2®) was used to seal colorectal anastomoses.

Main Results:

• No adverse reactions to CA were reported.
• No postoperative complications related to inflammation and adhesions occurred.
• A single case of AL (0.9%) was recorded, indicating a low leakage rate.

Conclusions:

• This study provides proof of concept for the safety of CA in sealing colorectal anastomoses.
• The findings support the initiation of prospective, comparative human studies to assess CA's efficacy in preventing colorectal AL.