Zhang Miao-Miao, Li Chen-Guang, Xu Shu-Qin, Mao Jian-Qi, Zhang Yu-Han, Shi Ai-Hua, Li Yan, Lyu Yi, Yan Xiao-Peng
Department of Hepatobiliary Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, Shaanxi Province, China.
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 Gastrointest Surg. 2023 Jul 27;15(7):1294-1303. doi: 10.4240/wjgs.v15.i7.1294.
Magnetic compression anastomosis (MCA) is a simple procedure contributing to a reliable anastomosis. However, digestive-tract reconstruction after total gastrectomy using MCA has not yet been reported.
To investigate the feasibility of MCA for simultaneous esophagojejunostomy and jejunojejunostomy after total gastrectomy using beagle dogs.
Sixteen beagles were randomly divided into an MCA group (study group, = 8) and a manual-suture anastomosis group (control group, = 8). Two different magnetic anastomosis devices were used in the study group for esophagojejunal and jejunojejunal anastomoses. Both devices included a pair of circular daughter and parent magnets each. The time of esophagojejunostomy and jejunojejunostomy, postoperative complications, and survival rate of the two groups were compared. The dogs were sacrificed one month after the operation and their anastomotic specimens were obtained. Healing was observed by the naked eye and a light microscope.
Digestive-tract reconstruction after total gastrectomy was successfully completed in both groups (survival rate = 100%). In the study group, esophagojejunal and jejunojejunal anastomoses took 6.13 ± 0.58 and 4.06 ± 0.42 min, respectively, significantly lower than those in the control group (15.63 ± 1.53 min, < 0.001 and 10.31 ± 1.07 min, < 0.001, respectively). Complications such as bleeding, anastomotic leakage, and anastomotic stenosis were not observed. In the study group, the magnets did not interfere with each other. Discharge time of the jejunojejunal magnetic anastomosis device was 10.75 ± 1.28 d, while that of the esophagojejunal magnetic anastomosis device was 12.25 ± 1.49 d. Residual silk was found in the control group. The study group showed a greater smoothness of the anastomosis than that of the control group. All layers of anastomosis healed well in both groups.
MCA is a safe and feasible procedure for digestive-tract reconstruction after total gastrectomy in this animal model.
磁性压缩吻合术（MCA）是一种简单的手术方法，有助于实现可靠的吻合。然而，尚未有关于使用MCA进行全胃切除术后消化道重建的报道。
探讨在比格犬身上使用MCA进行全胃切除术后同时行食管空肠吻合和空肠空肠吻合的可行性。
将16只比格犬随机分为MCA组（研究组，n = 8）和手工缝合吻合组（对照组，n = 8）。研究组使用两种不同的磁性吻合装置进行食管空肠和空肠空肠吻合。两种装置均各包括一对圆形子磁铁和母磁铁。比较两组的食管空肠吻合和空肠空肠吻合时间、术后并发症及生存率。术后1个月处死犬只，获取吻合标本。通过肉眼和光学显微镜观察愈合情况。
两组均成功完成全胃切除术后的消化道重建（生存率 = 100%）。研究组中，食管空肠吻合和空肠空肠吻合分别用时6.13±0.58分钟和4.06±0.42分钟，显著低于对照组（分别为15.63±1.53分钟，P<0.001和10.31±1.07分钟，P<0.001）。未观察到出血、吻合口漏和吻合口狭窄等并发症。研究组中，磁铁之间未相互干扰。空肠空肠磁性吻合装置的排出时间为10.75±1.28天，而食管空肠磁性吻合装置的排出时间为12.25±1.49天。对照组发现有残留丝线。研究组的吻合口比对照组更光滑。两组吻合口各层愈合良好。
在该动物模型中，MCA是全胃切除术后消化道重建的一种安全可行的方法。
