Application of α-cyanoacrylate medical glue for mesenteric fissure closure during laparoscopic radical resection of colorectal cancer

Abstract:

Background and Aims Whether to close mesenteric fissures during laparoscopic radical resection of colorectal cancer remains controversial. Traditional suture closure is technically demanding and may injure mesenteric vessels. This study aimed to evaluate the safety and efficacy of using α-cyanoacrylate medical glue to close mesenteric fissures during laparoscopic colorectal cancer surgery.Methods A retrospective analysis was conducted on patients who underwent laparoscopic radical resection of colorectal cancer in the Department of Colorectal Surgery, the Sixth Affiliated Hospital of Sun Yat-sen University, from January 2022 to December 2023. Seventy-eight patients who received intraoperative α-cyanoacrylate glue closure of mesenteric fissures were included as the observation group, and 74 patients without fissure closure were selected as the control group using the propensity score matching method. Perioperative parameters, postoperative recovery, and complications were compared between the two groups.Results No significant differences were observed in baseline characteristics or main intraoperative variables between groups (all P>0.05). The observation group had significantly less ascitic drainage within 3 days after operation [(203.14±116.44) mL vs. (384.53±243.89) mL, P<0.01] and shorter postoperative gas passage, defecation, and drainage tube removal times (all P<0.01). The incidence of postoperative complications and intestinal obstruction was comparable between groups (all P>0.05). Multivariate analysis showed that intraoperative application of α-cyanoacrylate glue was an independent promoting factor for intestinal exhaust within 3 days after surgery (OR=5.739, P=0.000).Conclusion The use of α-cyanoacrylate medical glue for closing mesenteric fissures during laparoscopic radical resection of colorectal cancer is safe and feasible. It effectively reduces postoperative ascitic drainage and accelerates bowel recovery, offering a simple and reliable alternative to traditional suture closure.