Tissue Adhesives in Experimental Intestinal Anastomoses
The aim of this study was to investigate the effects of a synthetic and a biological glue in intestinal anastomoses healing processes. An experimental model was also adopted for evaluating the possible side effects linked to fibrin glue use which are reported in different studies on colonic anastomoses. Twenty male New Zealand white rabbits (b. w. 3 ± 0.350 kg) under general anaesthesia were used. Animals were divided into three groups of six rabbits each and in two animals sham operation was performed. In 18 animals 5 cm of the left colon was resected by midline laparotomy. The anastomoses were performed using three different techniques: group I, single-layer end-to-end anastomosis with interrupted 6-0 polyglycolic acid stitches, group II: four 6-0 polyglycolic acid stitches at the cardinal points plus butyl-2-cyanoacrylate; and in group III, four 6-0 polyglycolic acid stitches at the cardinal points plus fibrin glue. Animals were killed under general anaesthesia at days 7,14 and 21 for macroscopic and histologic analysis.
No intra- or post-operative complications were observed. In group I, three cases of perianastomotic granuloma were observed, and in two animals modest adhesion formation was found. In group II, adhesion formation was evident and, moreover, one animal at day 7 had an anastomotic leakage. In the same group, two cases of a macroscopically evident stenosis of the anastomosis were observed at day 14. In group III, no macroscopical complications were noticed. With histologie study the anastomoses that had healed best were the ones in groups I and III, while in group II superficial necrosis of the perivisceral adipose tissue occurred.
The results show the possibility of performing intestinal anastomoses with glues at least in experimental conditions. Moreover, anastomoses performed with biological glue seem to be more reliable and have less side effects.
KeywordsToxicity Influenza Thrombin Ketamine Methacrylate
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