Department of Gastroenterological Surgery, Osaka Metropolitan University Graduate School of Medicine, 1-4-3 Asahi-machi Abeno-ku, Osaka City, Osaka Prefecture, 545-8585, Japan.
Sci Rep. 2024 Oct 30;14(1):26124. doi: 10.1038/s41598-024-77894-6.
Anastomotic-leakage incidence has been reported to be reduced on using polyglycolic acid (PGA) sheets as reinforcing materials; however, there is insufficient evidence regarding the reinforcement mechanism. Therefore, we investigated effects of PGA sheets on gastrointestinal anastomoses in rats. In the first approach, five rats underwent laparotomy; the PGA sheet was pasted onto the normal cecal wall. After five days, the cecum was removed and histologically evaluated. In the second approach, ten rats were randomly divided into two groups of five animals each. The rats underwent laparotomy; the cecal wall was sutured after a full-thickness incision. In the PGA group, a PGA sheet was used to cover the suture area. After 5 days, the cecum was removed, and the physical pressure resistance was evaluated. We confirmed the growth of a fibrous capsule measuring 855 (648-1048) µm outside the cecal serosa in the first approach. The median pressure resistance in the second approach was 57.0 (45.0-90.0) and 90.0 (82.5-94.5) mmHg in Control and PGA groups, respectively. The pressure resistance was significantly higher in the PGA group (p = 0.046). In summary, the PGA sheet may form a barrier of fibrosis on the intestinal wall and provide reinforcement to prevent anastomotic leakage.
吻合口漏的发生率在用聚乙二醇酸（PGA）片作为增强材料时已被报道降低；然而，关于增强机制的证据不足。因此，我们研究了 PGA 片对大鼠胃肠吻合的影响。在第一种方法中，五只大鼠接受了剖腹手术；PGA 片被粘贴到正常的盲肠壁上。五天后，取出盲肠并进行组织学评估。在第二种方法中，十只大鼠被随机分为两组，每组五只动物。大鼠接受剖腹手术；在全层切口后缝合盲肠壁。在 PGA 组中，使用 PGA 片覆盖缝合区域。五天后，取出盲肠，并评估物理压力阻力。我们在第一种方法中确认了在盲肠浆膜外生长的厚度为 855（648-1048）µm 的纤维胶囊。在第二种方法中，对照组和 PGA 组的中位压力阻力分别为 57.0（45.0-90.0）和 90.0（82.5-94.5）mmHg。PGA 组的压力阻力显著更高（p=0.046）。总之，PGA 片可能在肠壁上形成纤维性屏障，并提供增强作用以防止吻合口漏。
