Naoi Daishi, Horie Hisanaga, Koinuma Koji, Kumagai Yuko, Ota Gaku, Tojo Mineyuki, Kaneda Yuji, Hishikawa Shuji, Sadatomo Ai, Inoue Yoshiyuki, Fukushima Noriyoshi, Lefor Alan Kawarai, Sata Naohiro
Department of Surgery, Division of Gastroenterological, General and Transplant Surgery, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke, Tochigi, 329-0498, Japan.
Department of Pathology, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke , Tochigi, 329-0498, Japan.
Surg Today. 2021 Oct;51(10):1713-1719. doi: 10.1007/s00595-021-02267-9. Epub 2021 Mar 20.
The aim of this study was to evaluate both the intestinal mucosa staple line integrity and anastomotic leak pressure after healing in a porcine survival model.
We used two suture models using two different size staples (incomplete mucosal closure model: group G [staple height 0.75 mm], complete mucosal closure model: group B [staple height 1.5 mm]) in the porcine ileum. Five staple lines were created in each group made in the ileum for each model, and the staple sites harvested on days 0, 2, and 7. The leak pressure at the staple site was measured at each time point.
On day 0, the leak pressure for group G (79.5 mmHg) was significantly lower than that for group B (182.3 mmHg) (p < 0.01). On days 2 and 7, there was no significant difference between groups G and B (171 mmHg and 175.5 mmHg on day 2, 175.5 mmHg and 175.5 mmHg on day 7, p > 0.05). The histological findings in both groups showed similar healing at postoperative days 2 and 7.
The integrity of the mucosal staple lines was associated with the postoperative leak pressure on day 0. However, there was no association with the leak pressure at two days or more postoperatively in a porcine model.
本研究旨在评估猪存活模型愈合后肠道黏膜吻合钉合线的完整性和吻合口漏压力。
我们在猪的回肠中使用两种不同尺寸吻合钉的缝合模型(不完全黏膜闭合模型:G组[吻合钉高度0.75毫米],完全黏膜闭合模型:B组[吻合钉高度1.5毫米])。每组每种模型在回肠中制作5条吻合钉合线,并在第0、2和7天采集吻合钉部位。在每个时间点测量吻合钉部位的漏压力。
在第0天,G组的漏压力(79.5 mmHg)显著低于B组(182.3 mmHg)(p < 0.01)。在第2天和第7天,G组和B组之间无显著差异(第2天分别为171 mmHg和175.5 mmHg,第7天分别为175.5 mmHg和175.5 mmHg,p > 0.05)。两组的组织学结果显示术后第2天和第7天愈合情况相似。
黏膜吻合钉合线的完整性与术后第0天的漏压力相关。然而,在猪模型中,与术后两天或更长时间的漏压力无关。