磁吻合技术在大鼠全胃切除术后食管小肠吻合中的应用研究  

Magnetic compression anastomosis for esophagoenterostomy after total gastrectomy in rats

作　　者：陈环 单丽宇 吕毅[1,2] CHEN Huan;SHAN Liyu;L Yi(National Local Joint Engineering Research Center for Precision Surgery&Regenerative Medicine,The First Affiliated Hospital of Xi’an Jiaotong University,Xi’an 710061;Department of Hepatobiliary Surgery,The First Affiliated Hospital of Xi’an Jiaotong University,Xi’an 710061;Department of Hepatobiliary Surgery,The First Affiliated Hospital of Kunming Medical University,Kunming 650032,China)

机构地区：[1]西安交通大学第一附属医院精准外科与再生医学国家地方联合工程中心,陕西西安710061 [2]西安交通大学第一附属医院肝胆外科,陕西西安710061 [3]昆明医科大学第一附属医院肝胆外科,云南昆明650032

出　　处：《西安交通大学学报（医学版）》2023年第4期493-498,共6页Journal of Xi’an Jiaotong University（Medical Sciences）

摘　　要：目的胃切除术后消化道重建操作复杂、并发症多发。本研究旨在探究磁吻合技术实现大鼠全胃切除术后食管小肠免缝线吻合的可行性、安全性和有效性。方法24只大鼠随机分为两组,进行全胃切除。实验组采用磁吻合进行食管小肠重建,对照组采用手工缝合进行吻合。记录吻合口构建时间,观察术后大鼠生存情况,监测并发症,记录磁体排出时间。术后30 d对动物实施安乐死,获取标本,对比两组吻合口大体观、机械强度和病理变化等。结果实验组吻合时间为(12.9±2.7)min,低于对照组的(23.8±4.1)min(P=0.036)。实验组磁体排出时间为(7.42±1.4)d。实验组未发现吻合口漏、狭窄和出血等并发症,对照组4只大鼠出现吻合口漏或出血,均于术后4 d内死亡。两组吻合口爆破压相近,肉眼观吻合口愈合良好,组织学观察显示各层组织排列较好。结论磁吻合技术操作简单,术后并发症少,吻合口可靠,是实现全胃切除后消化道重建的安全可行的选择。Objective Digestive tract reconstruction after total gastrectomy is complicated and causes many complications.This study aimed to investigate the feasibility,safety and effectiveness of magnetic compression anastomosis(MCA)for sutureless reconstruction after total gastrectomy in rats.Methods Twenty-four rats were randomly apportioned to two groups.Reconstruction was performed with MCA in the experimental group or hand-sewn in the control group,and the construction time was recorded.The animals were followed up for 30 days.The survival rate and complications were monitored.At each time point,the rats were euthanized to study the gross/histological morphology and mechanical strength of the anastomoses.Results The reconstruction time was(12.9±2.7)min in the experimental group and(23.8±4.1)min in the control group(P=0.036).In the experimental group,there was no anastomotic complication.Four control rats developed anastomotic leakage or hemorrhage,and all died within 4 postoperative days.Compared with the control group,burst pressure in the experimental group was similar.Both groups’anastomoses had smooth gross appearance and histologically good alignment of tissue layers.Conclusion MCA is a safe and effective choice for reconstruction after total gastrectomy,with better postoperative outcomes than hand-sewn.

关 键 词：磁外科 磁吻合 全胃切除术 食管小肠吻合 消化道重建 

分 类 号：R4[医药卫生—临床医学]