可降解吻合环应用于犬肠切除、肠吻合的实验研究

目的:探讨可降解吻合环应用于犬的肠切除、肠吻合的可行性及其临床应用价值。方法:用20只本地杂种犬行肠切除、肠吻合术,将其随机分为两组:单一缝合组(对照组,n=10),应用可降解吻合环吻合组(实验组,n=10)。观察两组手术前后肠道内径的变化,记录缝合时间和总手术时间,观察术后1~10d肠瘘的发生率、支架降解情况,术后12周取吻合口处部分肠管组织做病理学检查。结果:实验组术后胆漏的发生率(1/10)与对照组(0/10)比较,差异无统计学意义(P>0.05);对照组的缝合时间(10.20±2.88)min多于实验组(2.02±1.03)min。术后第12周肠道吻合口病理学显示,实验组肠壁各层较好,炎性反应轻,无明显肉芽肿形成,浆膜层无纤维瘢痕,明显优于对照;对照组与实验组术后吻合口内径变化比较,差异无统计学意义(P>0.05)。结论:可降解吻合环应用于肠切除、肠吻合在动物实验中是安全有效的,且优于线缝合组。

Experimental study of valtrac ring used in intestinal anastomosis of dogs

Objective To assess the value of valtrac ring used for intestinal anastomosis by the animal experiment.Method We performed gastroenterostomy in 20 dogs.From the first day we intramascular injected all animals with Penicillin and gave them slop food.From the 8th postoperative day we gave them standard and fixed food,registered the change of bite and sub and weight.The postoperative serial X-ray examinations showed integration and disintegrated of that valtrac ring.When that valtrac ring didn′t appeared on X-ray examinations,all the dogs were killed and examined in gross and in microscope.Results The postoperative serial X-ray examinations showed that valtrac ring maintained good integration two weeks postoperation.The ring disintegrated into several small fragments that passed out of the body in feces from the 14th postoperative day after surgery.All of the dogs were killed on the 12th operative weeks and autopsied.The anastomosis site had smooth serosa and scar membrane in gross and were substituted by regenerative fibrous tissue.The specimen barim-air double contrast X-ray revealed that GI tract was coherent without leakage and stenosis.Conclusion Valtrac ring is easy to learn,convenient for use,safe and quick.It is better than conventional suture anastomosis and stapler in some aspects.Valreac is a safe and reliable alternative to manual and mechanical anastomosis in intestinal tumor surgery.