结肠液囊管一期修复结肠吻合口漏的动物实验研究

Colonic sac duct for first-stage repair of colon anastomotic leakage in miniature pigs

目的研制结肠液囊管作为一种安全可靠的新技术对结直肠吻合口漏进行有效的一期修复。方法将西藏小型猪随机分为2组,处理组与对照组,每组15头,处理组采用结肠液囊管对结肠吻合口漏进行一期修补,对照组以传统一期吻合口漏缝合近段结肠造瘘,二期结肠回纳手术。在修补术后第7、14、21天检测吻合口漏愈合情况:吻合口漏部位的愈合强度——爆破压、愈合部位组织中微血管密度及羟脯氨酸含量。结果结肠液囊管能够修复结肠吻合口漏,两组均无动物死亡,无肠管狭窄及坏死。术后第7、14天处理组爆破压、羟脯氨酸含量、微血管密度均高于对照组,但术后第21天两组无显著性差别。结论应用结肠液囊管技术一期修复结肠吻合口漏是安全、可靠且有效。特别是在结直肠吻合口漏48～72h以上,腹腔严重感染的环境下能有效修复结直肠吻合口漏。

Objective To study the efficacy,safety and reliability of colonic sac duct for first-stage repair of colorectal anastomotic leakage.Methods An animal model of colon anastomotic leakage was established in 30 Tibet miniature pigs,which were randomly divided into treatment group and control group（n=15）.Colon anastomotic leakage in the treatment group was repaired using the colonic sac duct,while the control group received conventional surgical repair.At 7,14,and 21 days after the surgery,the healing of the anastomotic leakage was evaluated by examining the bursting pressure,tissue microvessel density and hydroxyproline content at the anastomosis.Results Using the colonic sac duct,the anastomotic leakage was successfully repaired without death of the pigs or the occurrence of intestinal stenosis or necrosis.At 7 and 14 days after the surgery,the bursting pressure,hydroxyproline contents,and microvessel density in the treatment groups were higher than those in the control group,but such difference was not found at 21 days.Conclusion Colonic sac duct allows effective repair of colon anastomotic leakage,and is especially useful for leakage lasting for 48-72 h complicated by severe abdominal infection.