Departments of Surgery, Division of Pediatric Surgery, Pediatrics and Child Health, Children's Hospital Research Institute of Manitoba, University of Manitoba, Winnipeg, Manitoba, Canada.
Department of Radiology, Division of Pediatric Radiology, University of Chicago, Chicago, IL, USA.
J Pediatr Surg. 2020 May;55(5):821-823. doi: 10.1016/j.jpedsurg.2020.01.022. Epub 2020 Jan 30.
BACKGROUND/PURPOSE: Magnamosis is a novel technique which utilizes high power magnets to anastomose the esophageal ends in children with esophageal atresia (EA) with or without a tracheoesophageal fistula (TEF), theoretically avoiding the need for thoracotomy. The objective of this study was to compare anastomotic stricture formation requiring dilatation after magnamosis versus after conventional anastomosis.
Our center treated the first 3 cases of EA ± TEF with magnamosis in Canada. One was unsuccessful and excluded from our study. The number of postintervention dilatations was compared to controls from our database, which includes all children with EA ± TEF treated between 1991 and 2015. The controls had EA ± TEF treated with pouch-to-end anastomosis or colonic interposition (n = 65). Mann-Whitney U tests were used with p < 0.05 being significant.
The 2 magnamosis cases had a mean of 13.5 dilatations, compared to 2.6 for the controls. Those managed with pouch-to-end anastomosis or colonic interposition had a mean of 2.3 and 2.7 dilatations, respectively. We found that the cases required more dilatations than controls (p = 0.022) and pouch-to-end anastomosis (p = 0.021), but not than colonic interposition (p = 0.106).
Our results indicate that magnamosis is associated with more postintervention dilatations than conventional anastomotic techniques, suggesting that magnamosis results in more frequent and/or more resilient anastomotic strictures.
背景/目的：Magnamosis 是一种利用高功率磁铁吻合食管的新技术，适用于有或没有气管食管瘘（TEF）的食管闭锁（EA）患儿，理论上避免了开胸的需要。本研究的目的是比较吻合后狭窄形成需要扩张的情况，即在使用 magnamosis 吻合后与在使用常规吻合后。
我们中心在加拿大治疗了前 3 例 EA ± TEF 的病例，其中 1 例因技术失败而被排除在我们的研究之外。将介入后扩张的次数与我们数据库中的对照组进行比较，该数据库包括 1991 年至 2015 年间治疗的所有 EA ± TEF 患儿。对照组有 EA ± TEF 患儿采用袋状吻合或结肠间置术治疗（n = 65）。使用 Mann-Whitney U 检验，p < 0.05 为有统计学意义。
2 例 magnamosis 病例平均需要 13.5 次扩张，而对照组为 2.6 次。采用袋状吻合或结肠间置术治疗的患儿分别平均需要 2.3 和 2.7 次扩张。我们发现，与对照组（p = 0.022）和袋状吻合（p = 0.021）相比，病例需要更多的扩张，但与结肠间置术（p = 0.106）相比则不需要。
我们的结果表明，magnamosis 与传统吻合技术相比，术后需要更多的扩张，这表明 magnamosis 导致更频繁和/或更顽固的吻合口狭窄。
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