The effect of cyanoacrylate in esophagocutaneous leakages occurring after esophageal anastomosis

Objective: Esophageal leakage (EL) continues to be a challenging pediatric surgical problem. The aim of this study was to investigate the effect of cyanoacrylate (Cy) in EL followed esophageal repair (ER). Methods: Twelve rabbits were divided into control (C) and leakage (L) groups. A I cm-length transverse esophageal incision at the level of the cervical region was made. In both groups, feeding was started orally 24 h after the surgery for leakage creation. On postoperative day 7, primary repair was carried out in the C group and Cy instillation was performed in the L group. Esophagographic analysis was carried out on postoperative day 9 and the animals were fed orally on the same day on the condition that there was no esophageal leakage. The rabbits were sacrificed to measure diameters of the OR line, bursting pressure (BP), and hydroxyproline (HP) levels in the repaired cervical esophageal segment (RCES) 2 months later. Results: The values of BP and HP in the C group were significantly higher than those in the L group. The diameters of the OR line in the L group were significantly greater compared to those in the C group. Conclusions: Cy glue instillation seems to be the ideal treatment for esophageal anastomosis leakages as shown by increased diameters of the OR line and decreased HP levels. (C) 2009 Elsevier Ireland Ltd. All rights reserved.