Gastrointestinal anastomosis with Histoacryl glue in rats

Technical difficulties in creating gastrointestinal anastomosis in infants and young children, because of the small lumen, are well known and may be c omplicated by a narrow passage, anastomotic obstruction, gastric stasis, re current vomiting, and failure to gain weight. The search for alternative ea sier technique was the basis for this study. The primary aim was to evaluat e the safety of anastomosis between the stomach and a loop of the jejunum p erformed by using the tissue adhesive Histoacryl glue in comparison with th e same anastomosis performed conventionally with absorbable sutures. We com pared the results of gastrojejunal anastomosis in rats using either Histoac ryl (n-butyl cyanoacrylate) glue or continuous, absorbable sutures. Sixty-f our Sprague-Dawley rats were divided into 4 groups of 16 rats each. Gastroe nterostomy was performed with either type of anastomosis with and without t runcal vagotomy. The criteria of gastroenterostomy investigated included an astomotic leakage, stricture formation, adhesion formation, and histologica l examination. The pH of gastric secretion was measured with intact gastric innervation and after vagotmy in all rats. The time to complete each type of anastomosis was measured in minutes. Anastomotic stricture, leak, perito nitis, and death happened in three rats in each group with intact vagal inn ervation, in two rats after vagotomy and anastomosis with Histoacryl, and i n one rat after vagotomy and anastomosis with sutures. The results showed n o statistically significant differences between the various groups, except the shorter time for performing the glued anastomosis (5-7 min) compared to the conventional anastomosis (16-21 min). In conclusion, gastroenterostomy with Histoacryl in rats appears to be as safe as conventional suture anast omosis, saves operating time, and is not affected by gastric acidity.