Julián Ibáñez Joan F, Tarascó Palomares Jordi, Navinés López Jordi, Balibrea Del Castillo José M, Odermatt Erich K, Pacha González Miguel A, Del Castillo Riestra Luis F, Guardia Torner Natàlia, Turon Dols Pau, Fernández-Llamazares Rodríguez Jaime
Germans Trias I Pujol Hospital, Universitat Autònoma de Barcelona, Badalona (Barcelona), Spain
Germans Trias I Pujol Hospital, Universitat Autònoma de Barcelona, Badalona (Barcelona), Spain.
Surg Innov. 2016 Oct;23(5):490-7. doi: 10.1177/1553350616639142. Epub 2016 Mar 17.
Background Clinical effectiveness and safety of biological and synthetic adhesives in digestive closures have been evaluated. Their use is becoming more prevalent, as rigidity and inflexibility are its more remarkable weaknesses. However, little is known about their role in gastric and anastomotic closures. Moreover, usefulness of novel flexible types of synthetic adhesives as n-butyl-cyanoacrylate has not been assessed yet. Materials and Methods One centimeter long gastrotomy was performed in 24 male Wistar rats, which were divided depending on the type of closure method employed: manual USP 5/0 silk interrupted suture versus sutureless closure with Histoacryl Flexible (n-butyl-cyanoacrylate with softener) or Histoacryl Double Component (n-butyl-cyanoacrylate with softener and hardener). Microscopic evaluation of the suture viability and integrity was performed, and adhesion formation during the cicatrization process were assessed. During an 8-week follow-up clinical and histopathological aspects as well as hematologic and inflammatory biomarkers were studied. Results No differences among groups where found in any of the clinical, analytical, or histopathological issues assessed except for a higher incidence rate of adhesions in the Histoacryl Double Component group when compared with hand-sewn suture group (P = .04). Our results support experimental studies in large mammals (pigs) for further study of sutureless hollow viscera closure.
背景 已对生物和合成粘合剂在消化道闭合中的临床有效性和安全性进行了评估。由于其刚性和不灵活性是较为显著的缺点,它们的使用正变得越来越普遍。然而,人们对它们在胃和吻合口闭合中的作用知之甚少。此外,新型柔性合成粘合剂如正丁基氰基丙烯酸酯的效用尚未得到评估。 材料与方法 对24只雄性Wistar大鼠进行1厘米长的胃切开术,根据所采用的闭合方法类型将其分组:使用美国药典5/0丝线间断缝合与使用Histoacryl Flexible(含软化剂的正丁基氰基丙烯酸酯)或Histoacryl双组分(含软化剂和硬化剂的正丁基氰基丙烯酸酯)进行无缝合闭合。对缝线的活力和完整性进行显微镜评估,并评估瘢痕形成过程中的粘连形成情况。在8周的随访期间,研究临床和组织病理学方面以及血液学和炎症生物标志物。 结果 在所评估的任何临床、分析或组织病理学问题上,各实验组之间均未发现差异,但与手工缝合组相比,Histoacryl双组分组的粘连发生率更高(P = 0.04)。我们的结果支持在大型哺乳动物(猪)中进行实验研究,以进一步研究无缝合中空脏器闭合。
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