OBJECTIVE: Evaluation of preclinical feasibility and healing efficacy of a novel linear magnetic compression anastomosis (MCA) device to form a patent GJ versus sutured jejunal enterotomy (JE) sites in swine.
METHODS: Single-center veterinary testing facility.
METHODS: Feasibility of 3 prototype sizes (4, 6, and 8 cm) of a metal MCA device (MCAD) to form a patent GJ was evaluated over 6 weeks. A distal magnet was laparoscopically inserted in the jejunum, a proximal magnet was placed gastroscopically in the stomach; magnets were aligned to gradually form an anastomosis, self-detached, and be expelled. At necropsy, MCAs were assessed for patency and compared with JE tissues to evaluate wound healing.
RESULTS: MCADs aligned at the GJ location without complications. In 5/6 MCAD pairs, dislodgement occurred between 7 and 26 days; expulsion 13-31 days; 1 MCAD pair was retained in the stomach. At necropsy, all pigs were healthy, gaining a mean 15.0 kg. Anastomoses were not adequately patent in 2/4 pigs receiving the 4-cm or 6-cm MCADs because their linear length was too small. But, anastomoses of both pigs receiving the 8-cm MCADs maintained full patency. Minimal inflammation and fibrosis were seen in MCA specimens versus sutured enterotomies.
CONCLUSIONS: A novel linear MCA device was feasible and effectively created a patent GJ anastomosis in swine with minimal inflammation and fibrosis. The MCAD may be appropriate for clinical evaluation.
目的:评估新型线性磁性压缩吻合(MCA)装置在猪中形成专利GJ与缝合空肠肠切开术(JE)部位的临床前可行性和愈合效果。
方法:单中心兽医检测设施。
方法:在6周内评估了3种原型尺寸(4、6和8cm)的金属MCA装置(MCAD)形成专利GJ的可行性。远端磁铁通过腹腔镜插入空肠,在胃镜下将近端磁铁放置在胃中;将磁铁对齐以逐渐形成吻合口,自我分离,然后被开除.尸检时,评估MCA的通畅性,并与JE组织进行比较,以评估伤口愈合情况。
结果:MCADs在GJ位置对齐,无并发症。在5/6MCAD对中,移位发生在7至26天之间;排出13-31天;1对MCAD保留在胃中。尸检时,所有的猪都很健康,获得平均15.0公斤。在接受4-cm或6-cmMCADs的2/4猪中,吻合口不够通畅,因为它们的线性长度太小。但是,接受8厘米MCADs的两只猪的吻合口保持完全通畅。与缝合肠切开术相比,MCA标本中的炎症和纤维化最小。
结论:一种新颖的线性MCA装置是可行的,并且在猪中有效地创建了具有最小炎症和纤维化的专利GJ吻合术。MCAD可能适用于临床评估。