Chen Huan, Ma Tao, Wang Yue, Zhu Hao-Yang, Feng Zhe, Wu Rong-Qian, Lv Yi, Dong Ding-Hui
National Local Joint Engineering Research Center for Precision Surgery & Regenerative Medicine, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, Shaanxi Province, China.
World J Gastroenterol. 2020 Nov 14;26(42):6614-6625. doi: 10.3748/wjg.v26.i42.6614.
Although previous studies have confirmed the feasibility of magnetic compression anastomosis (MCA), there is still a risk of long-term anastomotic stenosis. For traditional MCA devices, a large device is associated with great pressure, and eventually increased leakage.
To develop a novel MCA device to simultaneously meet the requirements of pressure and size.
Traditional nummular MCA devices of all possible sizes were used to conduct ileac anastomosis in rats. The mean (± SD) circumference of the ileum was 13.34 ± 0.12 mm. Based on short- and long-term follow-up results, we determined the appropriate pressure range and minimum size. Thereafter, we introduced a novel "fedora-type" MCA device, which entailed the use of a nummular magnet with a larger sheet metal.
With traditional MCA devices, the anastomoses experienced stenosis and even closure during the long-term follow-up when the anastomat was smaller than Φ5 mm. However, the risk of leakage increased when it was larger than Φ4 mm. On comparison of the different designs, it was found that the "fedora-type" MCA device should be composed of a Φ4-mm nummular magnet with a Φ6-mm sheet metal.
The diameter of the MCA device should be greater than 120% of the enteric diameter. The novel "fedora-type" MCA device controls the pressure and optimizes the size.
尽管先前的研究已证实磁性压缩吻合术（MCA）的可行性，但仍存在长期吻合口狭窄的风险。对于传统的MCA装置，大型装置压力大，最终会增加渗漏。
研发一种新型MCA装置，以同时满足压力和尺寸要求。
使用所有可能尺寸的传统圆形MCA装置对大鼠进行回肠吻合术。回肠的平均（±标准差）周长为13.34±0.12毫米。基于短期和长期随访结果，我们确定了合适的压力范围和最小尺寸。此后，我们引入了一种新型“软毡帽型”MCA装置，该装置使用了带有更大金属片的圆形磁铁。
使用传统MCA装置时，当吻合器小于Φ5毫米时，吻合口在长期随访中出现狭窄甚至闭合。然而，当它大于Φ4毫米时，渗漏风险增加。比较不同设计发现，“软毡帽型”MCA装置应由一个Φ4毫米的圆形磁铁和一个Φ6毫米的金属片组成。
MCA装置的直径应大于肠管直径的120%。新型“软毡帽型”MCA装置可控制压力并优化尺寸。
