Effect of cyanoacrylate on closure of gastric perforation: a comparative study in a rat model.

The aim of the study was to compare suture, clip and clip combined with topical N-butyl cyanoacrylate in an experimental model of gastric perforation. Sixty Wistar-Albino rats were divided into three groups. Midline laparotomy was performed and a 4 mm puncture was done on the anterior surface of the stomach. Closure was performed by sutures in the first group, clip in the second group, and clip with topical cyanoacrylate in the third group. Ten rats underwent a re-laparotomy on the 3(rd) and 7(th) days, respectively. Intraabdominal adhesions, burst pressures, procedural time, total operation time and histological evaluation were analyzed. In the early phase, clip with topical cyanoacrylate treatment significantly improved burst pressures (p=0.001). In the late phase, burst pressure levels were slightly higher in the third group. Procedural period and total operation times were significantly higher in the suture-treated group and lower in the clip group. Clip with topical cyanoacrylate treatment improved histological healing indices, with significant difference in granulation, chronic inflammation and collagenisation scores, but at the expense of a significantly increased adhesion formation (P=0.001). Our study shows that gastric perforations can be effectively treated by the combination of clip and cyanoacrylate with shorter time and acceptable side-effects in selected cases.