Oesophageal clamp anastomosis and stricture formation. An experimental study in the piglet.

End-to-end oesophageal anastomoses were performed with a metal clamp in 8 piglets. A transanastomotic catheter was kept in position for 5 weeks following release of the clamp. The results were evaluated by contrast radiography after a further 2 weeks. All the animals survived the operation and the pre-determined observation period. All the anastomoses healed without signs of leakage. They showed strictures of varying degrees, as assessed by radiography of the specimens. The dissected specimens showed scarred changes in the anastomoses where the thin mucosa was regenerated. The results are explained by the fact that the method of clamp anastomosis per se leads to a mucosal defect at the site of anastomosis with ensuing secondary wound healing. The intraluminal tube therby prevents wound contraction with luminal obliteration by giving the mucosa time to regenerate.