Abstract：
BACKGROUND: To assess the feasibility of a deformable self-assembled magnetic anastomosis ring (DSAMAR) in the treatment of esophageal stenosis in beagle dogs via transoral access without temporary gastrostomy.
METHODS: Experimental esophageal stenosis was created in 10 beagle dogs by partial cervical esophageal ligation. The DSAMAR was inserted into the distal esophagus via the narrow section of the esophagus using a gastroscope. A circular DSAMAR was placed in the proximal esophagus. The magnetic rings on both sides of the experimental stenosis automatically attracted each other. We then recorded the operation time, postoperative complications, anastomotic formation time, and magnetic ring discharge time. The dogs were euthanized 4 weeks postoperatively; subsequently, we obtained the esophageal anastomotic specimens and observed the anastomotic formation via the naked eye and by light microscopy.
RESULTS: Our esophageal stenosis model produced reproducible stenoses in all dogs, which was confirmed via endoscopy and esophagography. DSAMAR was successfully implanted in all experimental animals under endoscopic and X-ray monitoring, and all linear DSAMARs were successfully transformed into rings. The magnets at both ends of the esophageal stenosis were automatically attracted. All animals survived until euthanasia. No complications, including esophageal perforation, bleeding, and gastrointestinal obstruction, were noted during the perioperative period. The mean operation time of endoscopic magnetic anastomosis was 15.6 ± 2.41 (range, 12-19) min. The mean esophageal anastomotic formation time was 8.8 ± 1.03 (range, 7-10) days, and the mean expulsion time of DSAMAR was 13.94 ± 2.88 (range, 10-19) days. Gastroscopy and esophagography were performed at 4 weeks postoperatively; the esophageal patency was good. Macroscopic observation of the esophageal anastomotic specimens revealed that the esophageal mucosal layer of the anastomosis had good continuity and the anastomosis was smooth.
CONCLUSIONS: DSAMAR is a feasible option for magnetic recanalization of esophageal stricture via transoral access without temporary gastrostomy.
METHODS: Experimental esophageal stenosis was created in 10 beagle dogs by partial cervical esophageal ligation. The DSAMAR was inserted into the distal esophagus via the narrow section of the esophagus using a gastroscope. A circular DSAMAR was placed in the proximal esophagus. The magnetic rings on both sides of the experimental stenosis automatically attracted each other. We then recorded the operation time, postoperative complications, anastomotic formation time, and magnetic ring discharge time. The dogs were euthanized 4 weeks postoperatively; subsequently, we obtained the esophageal anastomotic specimens and observed the anastomotic formation via the naked eye and by light microscopy.
RESULTS: Our esophageal stenosis model produced reproducible stenoses in all dogs, which was confirmed via endoscopy and esophagography. DSAMAR was successfully implanted in all experimental animals under endoscopic and X-ray monitoring, and all linear DSAMARs were successfully transformed into rings. The magnets at both ends of the esophageal stenosis were automatically attracted. All animals survived until euthanasia. No complications, including esophageal perforation, bleeding, and gastrointestinal obstruction, were noted during the perioperative period. The mean operation time of endoscopic magnetic anastomosis was 15.6 ± 2.41 (range, 12-19) min. The mean esophageal anastomotic formation time was 8.8 ± 1.03 (range, 7-10) days, and the mean expulsion time of DSAMAR was 13.94 ± 2.88 (range, 10-19) days. Gastroscopy and esophagography were performed at 4 weeks postoperatively; the esophageal patency was good. Macroscopic observation of the esophageal anastomotic specimens revealed that the esophageal mucosal layer of the anastomosis had good continuity and the anastomosis was smooth.
CONCLUSIONS: DSAMAR is a feasible option for magnetic recanalization of esophageal stricture via transoral access without temporary gastrostomy.
摘要：
背景：评估可变形的自组装磁性吻合环（DSAMAR）在通过经口进入而不进行临时胃造口术治疗比格犬食管狭窄中的可行性。
方法：通过部分颈食管结扎在10只比格犬中产生实验性食管狭窄。使用胃镜通过食管的狭窄部分将DSAMAR插入远端食管。将圆形DSAMAR放置在近端食管中。实验狭窄两侧的磁环自动相互吸引。然后我们记录了手术时间，术后并发症,吻合口形成时间,和磁环放电时间。术后4周对狗实施安乐死；随后，我们获得了食管吻合标本，并通过肉眼和光学显微镜观察了吻合口的形成。
结果：我们的食管狭窄模型在所有狗中都产生了可重复的狭窄，经内镜和食管造影证实。DSAMAR在内窥镜和X射线监测下成功植入所有实验动物，所有线性DSAMAR都成功转化为环。食管狭窄两端的磁铁被自动吸引。所有动物都存活下来直到安乐死。无并发症,包括食管穿孔,出血,和胃肠道阻塞，在围手术期被注意到。平均手术时间为15.6±2.41(范围,12-19）分钟。平均食管吻合口形成时间为8.8±1.03（范围，7-10）天，DSAMAR的平均驱逐时间为13.94±2.88(范围，10-19）天。术后4周行胃镜和食管造影，食管通畅良好。经食管吻合标本宏观观察，吻合口食管粘膜层连续性良好，吻合口光滑。
结论：DSAMAR是经口途径无临时胃造口术的食管狭窄磁性再通的可行选择。
方法：通过部分颈食管结扎在10只比格犬中产生实验性食管狭窄。使用胃镜通过食管的狭窄部分将DSAMAR插入远端食管。将圆形DSAMAR放置在近端食管中。实验狭窄两侧的磁环自动相互吸引。然后我们记录了手术时间，术后并发症,吻合口形成时间,和磁环放电时间。术后4周对狗实施安乐死；随后，我们获得了食管吻合标本，并通过肉眼和光学显微镜观察了吻合口的形成。
结果：我们的食管狭窄模型在所有狗中都产生了可重复的狭窄，经内镜和食管造影证实。DSAMAR在内窥镜和X射线监测下成功植入所有实验动物，所有线性DSAMAR都成功转化为环。食管狭窄两端的磁铁被自动吸引。所有动物都存活下来直到安乐死。无并发症,包括食管穿孔,出血,和胃肠道阻塞，在围手术期被注意到。平均手术时间为15.6±2.41(范围,12-19）分钟。平均食管吻合口形成时间为8.8±1.03（范围，7-10）天，DSAMAR的平均驱逐时间为13.94±2.88(范围，10-19）天。术后4周行胃镜和食管造影，食管通畅良好。经食管吻合标本宏观观察，吻合口食管粘膜层连续性良好，吻合口光滑。
结论：DSAMAR是经口途径无临时胃造口术的食管狭窄磁性再通的可行选择。
