一种涉及固定聚乙醇酸网片的新型结肠吻合技术。
A novel colonic anastomosis technique involving fixed polyglycolic acid mesh.
作者信息
Aysan Erhan, Bektas Hasan, Ersoz Feyzullah, Sari Serkan, Kaygusuz Arslan
机构信息
Department of General Surgery, Istanbul Educational and Research Hospital Istanbul, Turkey.
出版信息
Int J Clin Exp Med. 2010 Oct 24;3(4):341-6.
BACKGROUND
Polyglycolic acid mesh (PAM) reinforcement of colonic anastomoses were evaluated.
METHODS
Twenty female albino rabbits were divided into two groups. Each rabbit underwent segmental colonic resection with single-layer anastomosis. In one group of rabbits, PAM of length equal to the circumference of the anastomosis was applied. Rabbits were sacrificed on postoperative day 10 and peritoneal adhesions, anastomosis burst pressure, and anastomosis histopathological characteristics were evaluated.
RESULTS
The average burst pressure for the control and PAM groups was 149±15.95 mmHgand 224±124.5 mmHg, respectively (p=0.578). All control anastomoses burst, whereas only five (50%) PAM anastomoses burst (p<0.03). There was no anastomotic leakage in the control group, whereas three PAM group anastomoses leaked (p=0.210). The collagen fiber density and amount of neovascularization were lower in the PAM than the control group (p=0.001 and p=0.002, respectively). The average peritoneal adhesion value was 1.6±0.51 in the control group and 2.9±0.31 in the PAM group (p<0.0001).
CONCLUSION
The new fixed PAM-reinforced anastomosis technique resulted in an increased risk of anastomosis leakage and peritoneal adhesion, but also higher in non-burst anastomoses.
背景
评估聚乙醇酸网片（PAM）对结肠吻合口的加固作用。
方法
将20只雌性白化兔分为两组。每只兔子均接受结肠节段性切除并进行单层吻合。其中一组兔子应用长度等于吻合口周长的PAM。术后第10天处死兔子，评估腹膜粘连情况、吻合口破裂压力及吻合口组织病理学特征。
结果
对照组和PAM组的平均破裂压力分别为149±15.95 mmHg和224±124.5 mmHg（p = 0.578）。所有对照吻合口均破裂，而只有5个（50%）PAM吻合口破裂（p<0.03）。对照组无吻合口漏，而PAM组有3个吻合口漏（p = 0.210）。PAM组的胶原纤维密度和新生血管数量低于对照组（分别为p = 0.001和p = 0.002）。对照组的平均腹膜粘连值为1.6±0.51，PAM组为2.9±0.31（p<0.0001）。
结论
新的固定PAM加固吻合技术导致吻合口漏和腹膜粘连风险增加，但未破裂的吻合口情况较好。
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