加压吻合环应用于直肠低位前切除术的动物实验

Animal experimental study of compression anastomosis ring for low anterior resection

目的评价应用镍钛记忆合金加压吻合环（NITICAR27）在直肠低位前切除后进行端端吻合的可行性和安全性。方法6只小型猪行中远端直肠部分肠段切除．应用CAR27经肛门行直肠端端吻合。术后14d时，5只小型猪被实施安乐死；另1只在56d时也行安乐死；进行吻合口距肛缘距离和吻合口腔内周长的测量，并予以病理组织学检查。结果6只小型猪吻合口据肛缘距离平均5．3（4-6）cm；均无吻合口瘘及其他并发症发生，术后恢复顺利，体质量增加。14d时．在离体自然松弛状态下，吻合171腔内周长平均6．8（6．5～7．0）cm．组织病理学检查示有轻度的炎性反应及纤维化；56d时，吻合口腔内周长扩张到9．3cm．组织病理学检查示炎性反应及纤维化消失。吻合口浆膜面除1例轻微黏连外，其余均光滑完整，肉眼几乎不可辨别。结论镍钛记忆合金加压吻合环有希望作为一种新的吻合器械应用于低位直肠前切除术。

Objective To evaluate the feasibility and safety of nickel-titanium compression anastomosis ring （CAR27） in colorectal anastomosis after low anterior rectal resection in animal models. Methods End-to-end colorectal anastomosis was performed using CAR27 in 6 experimental pigs after resection of the middle and lower third of the rectum. The animals were observed postoperatively for up to 56 days. Five pigs were sacrificed at day 14 and the other at day 56. Distance from anal verge to anastomosis and anastomotic circumference were measured. Histopathologic examination was performed. Results The median distance from anal verge was 5.3（4-6）cm. No anastomotic leak or other complications were observed. All the pigs recovered and gained weight. In 5 animals sacrificed at day 14, the mean circumference of the anastomosis was 6.8（6.5-7.0）cm, and histopathological examination showed mild inflammatory reaction and fibrosis. In the one sacrificed at day 56, the circumference expanded to 9.3 cm, and no inflammation and fibrosis were observed. Minor adhesion was noticed in only one pig, while smooth and intact serosa in the anastomosis was seen in the rest of the animals. Conclusion CAR27 is a promising device for mid and low colorectal anastomosis.