BACKGROUND:The traditional hand-sewn Roux-en-Y choledochojejunostomy is technically complicated,and the incidence of postoperative complications has remained high.A set of novel magnetic compressive anastomats was int...BACKGROUND:The traditional hand-sewn Roux-en-Y choledochojejunostomy is technically complicated,and the incidence of postoperative complications has remained high.A set of novel magnetic compressive anastomats was introduced to facilitate choledochojejunostomy and improve the prognosis of patients.METHODS:After ligating the common bile duct for 7 days,16 dogs were randomly divided into two groups (n=8 per group).Anastomats were used in the study group,and the traditional hand-sewn method was used in the control group for standard Roux-en-Y choledochojejunostomy.We compared the operation time,incidence of complications,gross appearance,and pathological disparity in stoma between the two groups in 1-month and 3-month follow-up examinations.RESULTS:The time spent on constructing the anastomosis for the study group was significantly shortened.Although no anastomotic stenosis occurred in the two groups,the narrowing rate of biliary-enteric anastomosis was much higher in the control group.There was one case of bile leakage in the control group,whereas no bile leakage occurred in the study group.A smoother surface,an improved layer apposition,and a lower local inflammatory response were identified in the anastomosis of the study group.CONCLUSION:The structures of the novel magnetic compressive anastomats are simple,and they are time-saving,safe and efficient for performing Roux-en-Y choledocho- jejunostomy procedures in a canine model of obstructive jaundice.展开更多
BACKGROUND Although previous studies have confirmed the feasibility of magnetic compression anastomosis(MCA),there is still a risk of long-term anastomotic stenosis.For traditional MCA devices,a large device is associ...BACKGROUND Although previous studies have confirmed the feasibility of magnetic compression anastomosis(MCA),there is still a risk of long-term anastomotic stenosis.For traditional MCA devices,a large device is associated with great pressure,and eventually increased leakage.AIM To develop a novel MCA device to simultaneously meet the requirements of pressure and size.METHODS Traditional nummular MCA devices of all possible sizes were used to conduct ileac anastomosis in rats.The mean(±SD)circumference of the ileum was 13.34±0.12 mm.Based on short-and long-term follow-up results,we determined the appropriate pressure range and minimum size.Thereafter,we introduced a novel“fedora-type”MCA device,which entailed the use of a nummular magnet with a larger sheet metal.RESULTS With traditional MCA devices,the anastomoses experienced stenosis and even closure during the long-term follow-up when the anastomat was smaller thanΦ5 mm.However,the risk of leakage increased when it was larger thanΦ4 mm.On comparison of the different designs,it was found that the“fedora-type”MCA device should be composed of aΦ4-mm nummular magnet with aΦ6-mm sheet metal.CONCLUSION The diameter of the MCA device should be greater than 120%of the enteric diameter.The novel“fedora-type”MCA device controls the pressure and optimizes the size.展开更多
基金supported by a grant from the National Natural Science Foundation of China (30830099)
文摘BACKGROUND:The traditional hand-sewn Roux-en-Y choledochojejunostomy is technically complicated,and the incidence of postoperative complications has remained high.A set of novel magnetic compressive anastomats was introduced to facilitate choledochojejunostomy and improve the prognosis of patients.METHODS:After ligating the common bile duct for 7 days,16 dogs were randomly divided into two groups (n=8 per group).Anastomats were used in the study group,and the traditional hand-sewn method was used in the control group for standard Roux-en-Y choledochojejunostomy.We compared the operation time,incidence of complications,gross appearance,and pathological disparity in stoma between the two groups in 1-month and 3-month follow-up examinations.RESULTS:The time spent on constructing the anastomosis for the study group was significantly shortened.Although no anastomotic stenosis occurred in the two groups,the narrowing rate of biliary-enteric anastomosis was much higher in the control group.There was one case of bile leakage in the control group,whereas no bile leakage occurred in the study group.A smoother surface,an improved layer apposition,and a lower local inflammatory response were identified in the anastomosis of the study group.CONCLUSION:The structures of the novel magnetic compressive anastomats are simple,and they are time-saving,safe and efficient for performing Roux-en-Y choledocho- jejunostomy procedures in a canine model of obstructive jaundice.
文摘BACKGROUND Although previous studies have confirmed the feasibility of magnetic compression anastomosis(MCA),there is still a risk of long-term anastomotic stenosis.For traditional MCA devices,a large device is associated with great pressure,and eventually increased leakage.AIM To develop a novel MCA device to simultaneously meet the requirements of pressure and size.METHODS Traditional nummular MCA devices of all possible sizes were used to conduct ileac anastomosis in rats.The mean(±SD)circumference of the ileum was 13.34±0.12 mm.Based on short-and long-term follow-up results,we determined the appropriate pressure range and minimum size.Thereafter,we introduced a novel“fedora-type”MCA device,which entailed the use of a nummular magnet with a larger sheet metal.RESULTS With traditional MCA devices,the anastomoses experienced stenosis and even closure during the long-term follow-up when the anastomat was smaller thanΦ5 mm.However,the risk of leakage increased when it was larger thanΦ4 mm.On comparison of the different designs,it was found that the“fedora-type”MCA device should be composed of aΦ4-mm nummular magnet with aΦ6-mm sheet metal.CONCLUSION The diameter of the MCA device should be greater than 120%of the enteric diameter.The novel“fedora-type”MCA device controls the pressure and optimizes the size.
