Department of Hepatobiliary Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, 277 West Yanta Road, Xi'an, 710061, Shaanxi, People's Republic of China.
National Local Joint Engineering Research Center for Precision Surgery & Regenerative Medicine, Xi'an, 710061, People's Republic of China.
J Gastrointest Surg. 2019 Nov;23(11):2184-2192. doi: 10.1007/s11605-018-3888-5. Epub 2018 Aug 21.
This study evaluated a novel magnetic compression technique (magnamosis) for creating a portacaval shunt in a canine model of portal hypertension, relative to traditional manual suture.
Portal hypertension was induced in 18 dogs by partial ligation of the portal vein (baseline). Six weeks later, extrahepatic portacaval shunt implantation was performed with either magnetic anastomosis rings, or traditional manual suture (n = 9, each). The two groups were compared for operative time, portal vein pressure, and serum biochemical indices. Twenty-four weeks post-implantation, the established anastomoses were evaluated by color Doppler imaging, venography, and gross and microscopic histological examinations.
Anastomotic leakage did not occur in either group. The operative time to complete the anastomosis for magnamosis (4.12 ± 1.04 min) was significantly less than that needed for manual suture (24.47 ± 4.89 min, P < 0.01). The portal vein pressure in the magnamosis group was more stable than that in the manual suture group. The blood ammonia level at the end of the 24-week post-implantation observation period was significantly lower in the magnamosis group than in the manual suture group. Gross and microscopic histological examinations revealed that better smoothness and continuity of the vascular intima had been achieved via magnamosis than with manual suture.
Magnamosis was superior to manual suture for the creation of a portacaval shunt in this canine model of portal hypertension.
本研究评估了一种新型的磁压缩技术（magnamosis）在门静脉高压犬模型中创建门腔分流的效果，与传统的手动缝合技术进行比较。
18 只犬通过门静脉部分结扎（基线）诱导门静脉高压。6 周后，采用磁吻合环或传统手动缝合（每组 n=9）进行肝外门腔分流植入术。比较两组手术时间、门静脉压力和血清生化指标。植入后 24 周，通过彩色多普勒成像、静脉造影以及大体和显微镜组织学检查评估已建立的吻合口。
两组均未发生吻合口漏。完成 magnamosis 吻合的手术时间（4.12±1.04 分钟）明显短于手动缝合（24.47±4.89 分钟，P<0.01）。magnamosis 组门静脉压力更稳定。植入后 24 周观察期末，magnamosis 组的血氨水平明显低于手动缝合组。大体和显微镜组织学检查显示，magnamosis 比手动缝合更能实现血管内膜的平滑和连续性。
在门静脉高压犬模型中，magnamosis 比手动缝合更有利于创建门腔分流。
