Pirhan Yavuz, Gök Kadir, Gök Arif
Department of General Surgery, Sabuncuoğlu Şerefeddin Research and Training Hospital, Amasya University, Amasya, Turkey.
Department of Biomedical Engineering, Engineering and Architecture Faculty, Izmir Bakircay University, Izmir, Turkey.
Comput Methods Biomech Biomed Engin. 2020 Jun;23(8):323-331. doi: 10.1080/10255842.2020.1722809. Epub 2020 Feb 3.
The purpose of this study was to compare side-to-side and functional end-to-end anastomosis techniques that are commonly used in bowel surgery. Considering the dimensions of these two different anastomosis models, SolidWorks program was used for 3 D studies. Intra-intestinal flow analyzes were performed based on the finite volume method using Ansys Fluent, a computational fluid Dynamics (CFD) program. The flow velocity, pressure, turbulent knetic energy, turbulence vortex distribution, vortex viscosity and wall shear stresses for each model were calculated in results of the analysis for the side-to-side and functional end-to-end anastomosis technique. Due to the geometrical structure of the functional end - to - end anastomosis model, turbulence and hence the vortex formation is less than the side - to - side anastomosis technique. Because intersect area of bowels has wider in functional end - to - end anastomosis model, flow become easier than other. In surgical practice, functional end-to-end anastomosis is preferred over side-to-side anastomosis because of the low probability of leakage. It can be noted that the functional end - to - end anastomosis technique will be safer because of less turbulence, based on the data of fluid flow velocities, pressure, turbulent knetic energy, turbulence vortex distribution, vortex viscosity and wall shear stresses in the anastomosis.
本研究的目的是比较肠道手术中常用的侧侧吻合和功能性端端吻合技术。考虑到这两种不同吻合模型的尺寸,使用SolidWorks程序进行三维研究。基于有限体积法,使用计算流体动力学(CFD)程序Ansys Fluent进行肠内流动分析。在侧侧吻合和功能性端端吻合技术的分析结果中,计算了每个模型的流速、压力、湍动能、湍流涡旋分布、涡粘度和壁面剪应力。由于功能性端端吻合模型的几何结构,湍流以及因此形成的涡旋比侧侧吻合技术少。因为在功能性端端吻合模型中肠管的相交面积更宽,所以血流比其他情况更容易。在外科实践中,由于漏出概率低,功能性端端吻合比侧侧吻合更受青睐。根据吻合术中流体流速、压力、湍动能、湍流涡旋分布、涡粘度和壁面剪应力的数据,可以注意到功能性端端吻合技术由于湍流较少而更安全。