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Clinical Feasibility of Large Gastrotomy Closure Using a Flexible Tissue Glue Based on N-Butyl-2-Cyanoacrylate: Experimental Study in Pigs

  • Original Article
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Journal of Gastrointestinal Surgery Aims and scope

Abstract

Background

The use of synthetic adhesives such as cyanoacrylates has been established previously for a wide range of clinical indications. However, more research is necessary to evaluate their use in digestive closures or anastomosis. New chemical formulations developed to achieve more flexibility of synthetic adhesives (i.e., based on n-butyl-2-cyanoacrylate) could be an alternative to achieve this purpose. The aim of this study was to investigate the feasibility of using flexible cyanoacrylate adhesives for large gastric incision closure in an animal model.

Methods

Twelve farm pigs were divided in two groups depending on the type of closure method applied. In all cases, extra-large seven centimeters gastrostomies were performed. Braided absorbable hand-sewn interrupted suture versus n-butyl-2-cyanoacrylate with softener closure were compared during a 3-week follow-up period. Histopathological aspects, hematologic and inflammatory biomarkers, and endoluminal pressure tolerated until leakage were assessed. The time spent on both closing procedures was compared.

Results

No differences between the two groups were found in any of the histopathological and inflammatory variables evaluated. The glued group tolerated a significantly higher pressure than the manual suture group. A reduction of surgery time was also observed.

Conclusions

Our results suggest that flexible cyanoacrylates could be a feasible alternative to improve the clinical outcome of the closure of hollow viscera through more efficient sutureless procedures.

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Author information

Authors and Affiliations

  1. Department of Surgery, Germans Trias I Pujol Hospital, Universitat Autònoma de Barcelona, Hospital Germans Trias i Pujol, Carretera del Canyet s/n, 08916, Badalona (Barcelona), Spain

    Francisco Espin Alvarez, Jordi Navinés López, Jordi Tarascó Palomares, Iva Borisova, Jaime Fernández-Llamazares & Joan Francesc Julián Ibáñez

  2. B. Braun Surgical, S.A. Rubí (Barcelona), Spain

    Anna M. Rodríguez Rivero, Elena Díaz Celorio, Luís Felipe del Castillo Riestra & Pau Turon Dols

Authors
  1. Francisco Espin Alvarez
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  2. Anna M. Rodríguez Rivero
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  3. Jordi Navinés López
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  4. Elena Díaz Celorio
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  5. Jordi Tarascó Palomares
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  6. Luís Felipe del Castillo Riestra
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  7. Iva Borisova
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  8. Jaime Fernández-Llamazares
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  9. Pau Turon Dols
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  10. Joan Francesc Julián Ibáñez
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Contributions

JF. Julian and J. Fernández-Llamazares participated in the conception, design, surgical procedures in pigs and final critical revision.

P. Turon, AM Rodríguez, LF. del Castillo and E. Díaz participated in the conception, design, execution and final critical revision.

F. Espin and I. Vorisova contributed to analysis, interpretation of data, structure and drafting.

J. Navinés and J. Tarascó participated in the acquisition, analysis and interpretation of data.

Corresponding author

Correspondence to Francisco Espin Alvarez.

Ethics declarations

The authors declare that the Investigational Review Board and the Ethical committee of our institution approved the study and that they have no conflict of interest.

Conflict of Interest

The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article. The present work has been developed under agreement between B. Braun Surgical, S.A. and The Catalonian Public Health Institute (ICS), Barcelona, Spain. The authors disclosed that Histoacryl® Flexible was employed for investigational use. Histoacryl® Flexible is not approved for internal use, only for skin closure.

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Espin Alvarez, F., Rodríguez Rivero, A.M., Navinés López, J. et al. Clinical Feasibility of Large Gastrotomy Closure Using a Flexible Tissue Glue Based on N-Butyl-2-Cyanoacrylate: Experimental Study in Pigs. J Gastrointest Surg 23, 247–255 (2019). https://doi.org/10.1007/s11605-018-3910-y

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