Lacitignola Luca, Imperante Annarita, Desantis Salvatore
Dipartimento dell'Emergenze e trapianti di organi (D.E.T.O.), Sezione di Cliniche Veterinarie e produzioni animali, Università degli Studi di Bari "Aldo Moro", Bari, Italy.
Dottorato di ricerca in "Trapianti di Tessuti ed Organi e Terapie Cellulari", Dipartimento dell'Emergenza e dei Trapianti di Organi (DETO), Università degli Studi di Bari "Aldo Moro", Bari, Italy.
J Surg Res. 2022 Jul;275:235-243. doi: 10.1016/j.jss.2022.02.030. Epub 2022 Mar 17.
Off-label use of radiofrequency vessel sealing devices for intestinal thermofusion has been reported as an alternate approach for closing the small and large intestines. The study aimed to evaluate if reinforcing the thermofusion line with a modified N-butyl-2-CyanoAcrylate and methacryloxysulpholane produced improved burst pressure values in ex vivo swine jejunal loops.
A suture-less full-thickness jejunal biopsy was performed with different radiofrequency vessel-sealing devices (Ligasure 5 mm: RFVS-1; Atlast 10 mm: RFVS-2; Cayman Maryland: RFVS-3), and reinforcement with modified cyanoacrylate Glubran-2 (G2) at the thermofusion defect was applied. Burst pressure(BP) values were compared with a control group, wherein a cold blade was utilized to obtain the biopsy, followed by the closing of the jejunum with seven Gambee sutures.
Seventy (n = 70) jejunal loop samples were distributed into the experimental groups.The RFVS-1 and -2 groups exhibited BP values similar to those of the suture group. The RFVS-3 group showed significantly lower BP values (P < 0.05) than the suture group. Conversely, in the groups wherein G2 was applied, all BP values were comparable to those of the suture group. BP test in the RFVS-3G2 group showed significantly (P < 0.05) higher values in the group using the same instrument without the glue (RFVS-3).
G2 has been shown to improve the BP on the defects created by instruments that are not completely efficient in intestinal thermofusion and sealing. This experimental model showed that the performance of full-thickness biopsies with RFVS devices and reinforcement with G2 provide feasible and promising results.
据报道，将射频血管闭合装置用于肠道热融合的非标签使用是一种闭合小肠和大肠的替代方法。本研究旨在评估用改良的N-丁基-2-氰基丙烯酸酯和甲基丙烯酰氧基环丁砜强化热融合线是否能提高离体猪空肠肠袢的破裂压力值。
使用不同的射频血管闭合装置（5mm Ligasure：RFVS-1；10mm Atlast：RFVS-2；开曼马里兰：RFVS-3）进行无缝合全层空肠活检，并在热融合缺损处用改良氰基丙烯酸酯Glubran-2（G2）进行强化。将破裂压力（BP）值与对照组进行比较，对照组使用冷刀片获取活检样本，然后用7根Gambee缝线闭合空肠。
70个空肠肠袢样本被分配到实验组。RFVS-1组和-2组的BP值与缝合组相似。RFVS-3组的BP值显著低于缝合组（P<0.05）。相反，在应用G2的组中，所有BP值均与缝合组相当。RFVS-3G2组的BP测试显示，使用相同器械但不使用胶水的组（RFVS-3）的值显著更高（P<0.05）。
已证明G2可提高在肠道热融合和闭合方面不完全有效的器械所造成缺损处的BP。该实验模型表明，使用RFVS装置进行全层活检并使用G2进行强化可提供可行且有前景的结果。
