背景:磁压缩吻合(MCA)是一种简单的方法,有助于可靠的吻合。然而,尚未报道使用MCA进行全胃切除术后的消化道重建。
目的:探讨Beagle犬全胃切除术后同时行食管空肠吻合术和空肠吻合术的可行性。
方法:将16只小猎犬随机分为MCA组(研究组,n=8)和手动缝合吻合组(对照组,n=8)。研究组使用两种不同的磁性吻合装置进行食道空肠和空肠空肠吻合。两种设备都包括一对圆形的子磁体和母磁体。食管空肠吻合术和空肠吻合术的时间,术后并发症,比较两组患者的生存率。手术后1个月处死犬并获得吻合标本。通过肉眼和光学显微镜观察愈合。
结果:两组均成功完成全胃切除术后消化道重建(生存率=100%)。在研究小组中,食管空肠和空肠吻合时间为6.13±0.58和4.06±0.42分钟,分别,显著低于对照组(15.63±1.53min,P<0.001和10.31±1.07分钟,分别为P<0.001)。并发症如出血,吻合口漏,未观察到吻合口狭窄。在研究小组中,磁铁不会互相干扰。空肠空肠磁吻合器放电时间为10.75±1.28d,食管空肠磁吻合装置为12.25±1.49d。对照组有残留丝。研究组吻合的平滑度高于对照组。两组吻合层均愈合良好。
结论:在该动物模型中,MCA是一种安全可行的全胃切除术后消化道重建方法。
BACKGROUND: Magnetic compression anastomosis (MCA) is a simple procedure contributing to a reliable anastomosis. However, digestive-tract reconstruction after total gastrectomy using MCA has not yet been reported.
OBJECTIVE: To investigate the feasibility of MCA for simultaneous esophagojejunostomy and jejunojejunostomy after total gastrectomy using beagle dogs.
METHODS: Sixteen beagles were randomly divided into an MCA group (study group, n = 8) and a manual-suture anastomosis group (control group, n = 8). Two different magnetic anastomosis devices were used in the study group for esophagojejunal and jejunojejunal anastomoses. Both devices included a pair of circular daughter and parent magnets each. The time of esophagojejunostomy and jejunojejunostomy, postoperative complications, and survival rate of the two groups were compared. The dogs were sacrificed one month after the operation and their anastomotic specimens were obtained. Healing was observed by the naked eye and a light microscope.
RESULTS: Digestive-tract reconstruction after total gastrectomy was successfully completed in both groups (survival rate = 100%). In the study group, esophagojejunal and jejunojejunal anastomoses took 6.13 ± 0.58 and 4.06 ± 0.42 min, respectively, significantly lower than those in the control group (15.63 ± 1.53 min, P < 0.001 and 10.31 ± 1.07 min, P < 0.001, respectively). Complications such as bleeding, anastomotic leakage, and anastomotic stenosis were not observed. In the study group, the magnets did not interfere with each other. Discharge time of the jejunojejunal magnetic anastomosis device was 10.75 ± 1.28 d, while that of the esophagojejunal magnetic anastomosis device was 12.25 ± 1.49 d. Residual silk was found in the control group. The study group showed a greater smoothness of the anastomosis than that of the control group. All layers of anastomosis healed well in both groups.
CONCLUSIONS: MCA is a safe and feasible procedure for digestive-tract reconstruction after total gastrectomy in this animal model.