Department of Surgery, International University of Health and Welfare Hospital, Iguchi, Nasushiobara City, Tochigi, Japan.
Department of Surgery, International University of Health and Welfare Hospital, Iguchi, Nasushiobara City, Tochigi, Japan.
J Am Coll Surg. 2021 Feb;232(2):170-177.e2. doi: 10.1016/j.jamcollsurg.2020.10.012. Epub 2020 Oct 22.
Magnetic compression anastomosis (MCA) is a novel technique of anastomosis similar to that with surgery, but in a minimally invasive manner. Few reports are available on the utility and feasibility of MCA for gastrointestinal anastomosis without requiring general anesthesia in humans, owing to the difficulty of delivering magnets. We evaluated the safety, efficacy, and feasibility of MCA in gastrointestinal obstruction without requiring general anesthesia.
In this retrospective single-center study, patients who underwent MCA from January 2013 to October 2019 were included. Adult patients with gastrointestinal obstruction or stenosis, irrespective of the underlying disease, with severe comorbidities, complicated abdominal surgical history, or postoperative complications, and who were unable to tolerate surgery, were eligible for inclusion. Two magnets were delivered by a combination of endoscopic and fluoroscopic procedures and placed in the lumen of the organ to be anastomosed. The main outcome was the technical success of MCA.
Fourteen patients underwent MCA, and the technical success of MCA was achieved in 100% of the cases. The mean procedural time, duration for anastomosis formation, and postoperative hospital stay were 44 minutes, 13 days, and 36 days, respectively. Two patients underwent anastomotic restenosis, and 1 patient had an anastomotic perforation due to balloon dilatation to prevent restenosis. The mean follow-up period was 34 months.
MCA without general anesthesia for gastrointestinal anastomosis is safe, useful, and feasible. MCA can be a valuable alternative to surgery in gastrointestinal obstruction.
磁压缩吻合术（MCA）是一种类似于手术的新型吻合技术，但采用微创方式。由于难以递送磁铁，因此很少有关于在不使用全身麻醉的情况下通过 MCA 进行胃肠吻合的实用性和可行性的报告，因为在人类中。我们评估了在不使用全身麻醉的情况下治疗胃肠梗阻的 MCA 的安全性、疗效和可行性。
在这项回顾性单中心研究中，纳入了 2013 年 1 月至 2019 年 10 月期间接受 MCA 的患者。患有胃肠梗阻或狭窄的成年患者，无论基础疾病如何，均有严重合并症、复杂腹部手术史或术后并发症，且无法耐受手术的患者，符合纳入标准。通过内镜和透视程序的组合将两个磁铁递送到要吻合的器官的管腔中。主要结局是 MCA 的技术成功率。
14 名患者接受了 MCA，MCA 的技术成功率达到 100%。平均手术时间、吻合形成时间和术后住院时间分别为 44 分钟、13 天和 36 天。2 名患者发生吻合口再狭窄，1 名患者因球囊扩张以防止再狭窄而发生吻合口穿孔。平均随访时间为 34 个月。
不使用全身麻醉的 MCA 用于胃肠吻合是安全、有用和可行的。MCA 可以成为胃肠梗阻的一种有价值的手术替代方法。
