title: Critical analysis of cyanoacrylate in intestinal and colorectal anastomosis.
abstract: BACKGROUND
  Although cyanoacrylate glue (CA) has been widely used in various kinds of medical applications, its application in gastrointestinal anastomosis remains limited, and outcomes of experimental studies have not been satisfactory. This systematic review summarizes research regarding CA application in intestinal and colorectal anastomosis, and correlates methodological aspects to experimental outcomes.
  
  
  METHODS
  A systematic literature search was performed using Medline, Embase, Cochrane, and Web-of-Science libraries. Articles were selected if CA was applied to intestinal or colorectal anastomoses. Included articles were categorized according to CA molecular structure; the method details in each study were extracted and analyzed.
  
  
  RESULTS
  Twenty-two articles were included. More than half of the inclusions reported positive outcomes (seven articles) or neutral outcomes (eight articles). Analysis of the methods revealed that methodological details such as CA dosage, time of polymerization were not consistently reported. Porcine studies, inverted anastomosis, and n-butyl-cyanoacrylate studies showed more positive outcomes; everted anastomosis, and oversized sutures might negatively influence the outcomes.
  
  
  CONCLUSIONS
  Owing to the positive outcome from the porcine studies, application of CA in gastrointestinal (GI) anastomosis still seems promising. To achieve a better consistency, more methodological details need to be provided in future studies. Optimizing the dosage of CA, choice of animal model, inverted anastomosis construction, and other method details may improve intestinal and colorectal anastomoses with CA application in future studies.
authors.affiliation: Department of Surgery, Erasmus University Medical Center, Rotterdam, The Netherlands.
authors.forename: Zhouqiao
authors.initials: Z
authors.lastname: Wu
authors.forename: Geesien S A
authors.initials: GS
authors.lastname: Boersema
authors.forename: Konstantinos A
authors.initials: KA
authors.lastname: Vakalopoulos
authors.forename: Freek
authors.initials: F
authors.lastname: Daams
authors.forename: Cloe L
authors.initials: CL
authors.lastname: Sparreboom
authors.forename: Gert-Jan
authors.initials: GJ
authors.lastname: Kleinrensink
authors.forename: Johannes
authors.initials: J
authors.lastname: Jeekel
authors.forename: Johan F
authors.initials: JF
authors.lastname: Lange
mesh_terms: D000714:Anastomosis, Surgical / Q000379:methods*; D000818:Animals; D001672:Biocompatible Materials / Q000737:chemistry; D002015:Bucrylate / Q000737:chemistry; D003106:Colon / Q000601:surgery*; D003487:Cyanoacrylates / Q000737:chemistry; D013505:Digestive System Surgical Procedures / Q000379:methods*; D004285:Dogs; D004659:Enbucrilate / Q000737:chemistry; D006801:Humans; D007422:Intestines / Q000601:surgery*; D008422:Materials Testing; D051381:Rats; D012007:Rectum / Q000601:surgery*; D014014:Tissue Adhesives
chemical_list: D001672:Biocompatible Materials; D003487:Cyanoacrylates; D014014:Tissue Adhesives; C558475:poly(ethylcyanoacrylate); D002015:Bucrylate; D004659:Enbucrilate; C008424:methyl 2-cyanoacrylate
keywords: anastomotic leakage; colorectal anastomosis; cyanoacrylate; sealant; sutureless