Department of General Surgical Science (Surgery I), Gunma University Graduate School of Medicine, 3-39-22 Showa-Machi, Maebashi, Gunma, 371-8511, Japan.
Dig Dis Sci. 2010 Sep;55(9):2489-97. doi: 10.1007/s10620-009-1040-9. Epub 2009 Nov 14.
The objective of this study is to compare the postoperative motility between hand-sewn end-to-end anastomosis and functional end-to-end anastomosis.
Fifteen conscious dogs were divided into three groups: normal intact dog group, end-to-end anastomosis group (EE), and functional end-to-end anastomosis group (FEE). In the EE and FEE groups, the dogs underwent a transection of the jejunum 30 cm distal to the Treitz ligament and anastomosis in each method. To compare the gastrointestinal motility, the time to the appearance and the rate of propagation of interdigestive migrating motor contractions (IMC) across the anastomosis, as well as the motility index (MI) at the oral and anal sides of the anastomosis, were measured using strain gauge force transducers. Furthermore, the histological examination of intrinsic nerve fibers was evaluated.
The time to the appearance of propagation of IMC in the EE and FEE was not significantly different. The propagation rates of IMC in the EE and FEE completely recovered within 4 weeks of the surgery. The MI in the EE and FEE was not significantly different. In addition, no continuity of intrinsic nerve fibers across the anastomosis could be identified in either group.
In the present study, there are no significant differences between the EE and FEE with regard to the time of the appearance and the rate of propagation of IMC. These results suggest that the effect of functional end-to-end anastomosis on postoperative motility is not different from that of hand-sewn end-to-end anastomosis.
本研究旨在比较手工端端吻合与功能性端端吻合术后的运动功能。
15 只清醒犬分为三组:正常完整犬组、端端吻合组(EE)和功能性端端吻合组(FEE)。在 EE 和 FEE 组,距 Treitz 韧带 30cm 处切断空肠,并采用相应方法进行吻合。为了比较胃肠运动功能,采用应变片压力传感器测量吻合口处间位性移行性复合运动(IMC)出现的时间和传播速度,以及吻合口口侧和肛侧的运动指数(MI)。此外,还评估了固有神经纤维的组织学检查。
EE 和 FEE 中 IMC 传播的出现时间无显著差异。EE 和 FEE 中 IMC 的传播速度在手术后 4 周内完全恢复。EE 和 FEE 的 MI 无显著差异。此外,在两组中均未发现吻合口处固有神经纤维的连续性。
本研究中,EE 和 FEE 在 IMC 出现时间和传播速度方面没有显著差异。这些结果表明,功能性端端吻合术对术后运动功能的影响与手工端端吻合术无差异。