KEY TAKEAWAYS
- The ReAL study aimed to evaluate nebulized modified cyanoacrylate for preventing AL after the rectal surgery.
- Modified cyanoacrylate has safe and AL rates between reinforced and unreinforced groups over 30 days.
Anastomotic leakage (AL) is the most common life-threatening complication following colorectal cancer surgery. Numerous efforts have been undertaken to prevent AL, yet it remains a significant concern in postoperative care.
Giovanni Tomasicchio and the team aimed to assess the safety and efficacy of nebulized modified cyanoacrylate in preventing AL after rectal surgery.
They analyzed patients undergoing colorectal surgery for high-medium rectal carcinoma at 5 high-volume centers from June 2021 to January 2023. The participants were randomized into Group A (receiving anastomotic reinforcement with cyanoacrylate) and Group B (no reinforcement), followed up for 30 days. Group A received 1 ml of modified cyanoacrylate via nebulization. Preoperative, intraoperative, and postoperative data were recorded and compared.
Results indicated that out of 152 patients, 133 completed the follow-up (control group: 72, cyanoacrylate group: 61); in the control group, 9 patients (12.5%) experienced ALs (4 grade B, 5 grade C), while 4 patients (6.6%) in the cyanoacrylate group had ALs (3 grade B, 1 grade C).
Although this trend wasn’t statistically significant (P=0,36), Clavien-Dindo complications grade>2 were significantly higher in the control group (12.5% vs. 3.3%, P=0.04). No adverse effects from the glue were reported.
The study concluded that the role of modified cyanoacrylate in preventing AL remains uncertain. However, its application to seal colorectal anastomoses is safe and may reduce severe postoperative complications.
The study was funded by the Università degli Studi di Bari Aldo Moro.
Source: https://pubmed.ncbi.nlm.nih.gov/39103661/
Clinical Trial: https://clinicaltrials.gov/study/NCT03941938
Tomasicchio G, Martines G, Tartaglia N, et al. (2024). “Suture reinforcement using a modified cyanoacrylate glue to prevent anastomotic leak in colorectal surgery: a prospective multicentre randomized trial.” 2024 Aug 5;28(1):95. doi: 10.1007/s10151-024-02967-7. PMID: 39103661.
