The Adjunctive Effect of DuraSeal® vs. 2-Octyl-Cyanoacrylate on Delayed Repair of Gastric Perforation: An Experimental Study
Journal of Investigative Surgery, cilt.35, sa.3, ss.542-548, 2022 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 35 Sayı: 3
- Basım Tarihi: 2022
- Doi Numarası: 10.1080/08941939.2021.1887414
- Dergi Adı: Journal of Investigative Surgery
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Academic Search Premier, EBSCO Legal Collection, EBSCO Legal Source, EMBASE, MEDLINE
- Sayfa Sayıları: ss.542-548
- Anahtar Kelimeler: cyanoacrylate, delayed closure, DuraSeal, Gastric perforation, surgery, ®
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
Objective: Delayed primary suture closure of gastric perforation is prone to dehiscence hence the repaired area should be buttressed to avoid re-operation. We aimed to investigate whether DuraSeal®(DS) has a potent adjunctive effect on delayed closure of gastric perforation comparing with 2-octly-cyanoacrylate(CYN) in an experimental model. Methods: Sixty rats were randomly divided into 6 groups. All subjected to gastric perforation, subsequently perforation areas were repaired by primary suturing, delayed repair was performed 12 h after surgery. According to DS or CYN application on anastomosis, the groups were classified as control(C), delayed control(CD), closure with CYN(CYN), delayed closure with CYN(D-CYN), closure with DS(DS), delayed closure with DS(D-DS).After euthanization on POD 7,anastomotic bursting pressure(ABP) were measured. Tissue samples were taken for histopathological examination and hydroxyproline(TH) assessment. Results: Delayed condition significantly reduced ABP and TH levels in CD group comparing with all groups(p < 0.01).Either CYN or DS application on delayed repaired area significantly raised the measure of ABP and TH up to the levels of C group(p < 0.05,comparing with CD).Microscopically,either CYN or DS application significantly improved tissue necrosis, submucosal bridging and collagen formation comparing with CD group(p < 0.012).There were no difference regarding ABP, TH and tissue healing between each CYN and DS groups. Conclusion: DuraSeal® application on sutured gastric perforation area yielded a significant adjunctive effect both in normal and delayed conditions. However, DuraSeal® revealed no superior effect to CYN in both condition.Our results demonstrated that the clinical use of DuraSeal® can be considered for reinforcing the sutured line in patients undergoing delayed surgery for gastric perforation.