Zhang Miaomiao, Zhao Xuhe, Zhong Qiuye, Shen Linxin, Gong Ruimin, Lyu Yi, Yan Xiaopeng
Department of Hepatobiliary Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, No.277 Yanta West Road, Xi'an, 710061, Shaanxi, China.
Shaanxi Provincial Key Laboratory of Magnetic Medicine, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China.
Sci Rep. 2024 Dec 3;14(1):30042. doi: 10.1038/s41598-024-81856-3.
Magnetic compression anastomosis (MCA) for esophageal stenosis requires the insertion of magnets through two channels, transoral and transgastrostomy. Herein, we designed a Y-Z deformable self-assembled magnetic anastomosis ring (Y-Z DSAMAR) for esophageal stricture anastomosis through the transoral passage only. We introduce a Y-Z DSAMAR and verify its feasibility for single-access esophageal stenosis anastomosis in isolated organs. We procured esophagi from 10 pigs. Next, we ligated the middle part of these esophagi with 7 - 0 silk to prepare an esophageal stenosis model. The linear Y-Z DSAMAR completed the deformation self-assembly and transitioned from its initial linear shape to a circular one while passing through the esophageal stenosis. The operation time, the success rate of the deformation self-assembly of Y-Z DSAMARs, and the successful MCA for esophageal stenosis were recorded. We successfully obtained a trapezoidal magnetic unit. Ten such magnetic units can self-assemble into a ring after the hard guide wire is withdrawn. The success rates for both self-assembly deformation and esophageal stenosis anastomosis were 93.33%, while that for esophageal stenosis anastomosis with successful deformation was 100%. Y-Z DSAMARs exhibit remarkable deformation-controllable characteristics. Further optimization of the operational procedure and verification through animal experiments are needed before they can be clinically applied.
用于食管狭窄的磁性压缩吻合术（MCA）需要通过经口和经胃造口两个通道插入磁体。在此，我们设计了一种仅通过经口通道用于食管狭窄吻合的Y-Z可变形自组装磁性吻合环（Y-Z DSAMAR）。我们介绍了Y-Z DSAMAR，并验证了其在离体器官中进行单通道食管狭窄吻合的可行性。我们从10头猪身上获取食管。接下来，我们用7-0丝线结扎这些食管的中部以制备食管狭窄模型。线性的Y-Z DSAMAR完成了变形自组装，并在通过食管狭窄时从其初始线性形状转变为圆形。记录手术时间、Y-Z DSAMAR变形自组装的成功率以及食管狭窄磁性压缩吻合术的成功率。我们成功获得了一个梯形磁性单元。拔出硬导丝后，十个这样的磁性单元可以自组装成一个环。自组装变形和食管狭窄吻合的成功率均为93.33%，而变形成功的食管狭窄吻合成功率为100%。Y-Z DSAMAR具有显著的变形可控特性。在临床应用之前，需要进一步优化手术操作流程并通过动物实验进行验证。
