Terminolateral esophagojejunostomy after gastrectomy with the biofragmentable anastomosis ring in the dog model |
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Authors: | Dietz U A Araújo A C F Czeczko N G Lemos R Araújo U Inácio C M Salles G Corrêa Neto M Repka J C D Zanellato C M F Malafaia O Debus E S Thiede A |
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Affiliation: | Universit?tsklinikum Würzburg, Chirurgische Klinik I, 97080 Würzburg. Dietz_U@chirurgie.uni-wuerzburg.de |
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Abstract: | INTRODUCTION: Esophagojejunostomy after total gastrectomy still remains a high risk anastomosis with a considerable morbidity and mortality. The majority of these anastomoses are performed by the intraluminal stapler technique, yet stenoses are a known late complication even after an uneventful postoperative course. In the present study, the osophagojejunostomy with the biofragmentable anastomosis ring (BAR) was examined in dogs. METHODS: 28 dogs were randomized into a group of manual suture (n = 14) and a BAR-group (n = 14). After gastrectomy, the esophagojejunostomy was performed by hand-suture with polypropylene 4-0 in the manual suture group, and with the 25/1.5 mm BAR in the BAR-group. In both groups the Roux-en-Y jejunojejunostomy was performed by hand-suture. The dogs were evaluated on postoperative days 4, 7 and 14 with regard to macroscopy, bursting strength, tissue hydroxyproline and histology. RESULTS: There was one leakage without clinical effect in the hand-sewn group on postoperative day 4; there was no leak in the BAR-group. In observing fibre-free enteral feeding, neither functional disorders nor obstruction of the BAR were observed. The general anastomosis parameters were matchable between the groups. CONCLUSION: The infracarinal BAR-esophagojejunostomy is comparable to the hand-sewn anastomosis in the dog-model. |
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