The objectives of the study and likely risks involved were described to patients’ parents, and written parental consents were obtained before using the product. The trial included five cases with tracheoesophageal fistula, one case of penoscrotal hypospadias, one case of urethocutanouse fistula and two cases of extrophy complex with vesicocutanouse
fistula. 1- Cases with Tracheosophageal Fistula The glue was used in five cases of tracheoesophageal atresia and fistula (TEF). In a 2-day-old girl the glue was used to cover the Inhibitors,research,lifescience,medical native esophagus and fistula to minimize the incidence of reopening due to fragile tissue. Three of the patients (with an age range of two to eight months) had recurrent fistula following the esophageal dilatation. In such patients, under endoscopic Inhibitors,research,lifescience,medical guidance, the fistulas were first de-epithelialzed with a Bugbee diathermy electrode (5-15 W), and then were sealed with the glue completely. Antibiotic (cefexime [Tolid Daro, ] at 50 mg/kg/day) were used during the treatment. The closure of the fistula was checked by bronchoscopy four weeks later (figure 1). Inhibitors,research,lifescience,medical We also used the glue in a premature 5-day-old girl who had a very low birth weight and pneumonia. She underwent temporary sealing of the large Afatinib clinical trial carinal fistula with bronchoscope,4 for stabilizing her before the definitive operation. Figure
1 The posterior aspect of the closure of recurrent tracheoes The postoperative recurrent TEF
were closed by transbrochoscopic glue injection within 4 weeks. They were followed up for six months, during which no recurrence occurred. One TEF case with a fragile anastomosis was protected by covering the anastomosis Inhibitors,research,lifescience,medical with glue, which prevented anastomosis leakage. The unstable TEF case with pneumonia, which had a temporary fistula closure, underwent a definitive operation later and survived. 2- Pediatric Urological Cases Two pediatric urological Inhibitors,research,lifescience,medical cases were also used to examine the effectiveness of the glue. One was a two-year-old boy, who was a case of penoscrotal hypospadias, and the other was a 4-year-old boy with urethocutanouse fistula. Both underwent glue coverage after surgery using a thin layer of glue on suture line of urethroplasty, and a thick layer of glue between dartus flap and skin coverage (figure 2,,33).5 Two extrophy complex cases had vesicocutanouse crotamiton fistulas. The fistula tracts were first deepithelized, and then were filled by glue. The free drainage of bladder was performed as well. Figure 2 The placement of glubran 2 on urethroplasty in severe hpospadias Figure 3 A dissected urethrocutanouse fistula in hypospadias, which was reinforced by glubran The thick layer of glue, which was used between dartus flap and skin in the two cases of hypospadias caused necrosis of skin; therefore, the necrosis of skin was repaired again.