中国现代手术学杂志2025，Vol.29Issue(2)：87-91,5.DOI:10.16260/j.cnki.1009-2188.2025.02.001
倾斜适形吻合对提高猪食管胃吻合口抗拉强度的作用
The effect of oblique conformal anastomosis in enhancing the tensile strength of porcine esophagogastric anastomosis
摘要
Abstract
Objective To evaluate the efficacy of oblique conformal anastomosis in enhancing the ten-sile strength of esophagogastric anastomoses using porcine esophagus stomach ex vivo specimens.Methods A total of 27 fresh porcine esophagi and stomach ex vivo specimens were utilized to construct esophagogastric anastomosis models.Nine models with comparable weights were randomly assigned into three groups,where esophagogastric oblique anastomosis and conventional end-to-side anastomosis were performed using circular staplers.A disposable stapler was used to remove the lesser curvature of the stomach and preserve the greater curvature to create a tubular stomach.And end-to-side anastomosis of the gastroesophageal region on the posterior wall of the greater curvature of the stomach was performed using a disposable tubular stapler at 0°,30°,and 45°,respectively.The residual ends of the stomach and esophagus were closed with a disposable stapler at 5cm above and below the anastomotic site,and embed the residual ends using 2-0 silk thread to intermittently suture of the muscular layer.Then the experimental specimen was fixed vertically on the tensile testing platform,and was slowly pulled open the anastomosis.Once the muscle layer of the anastomotic site ruptured,the mucosa around the anastomotic site would be observed,indicating the occurrence of anastomotic leakage.The tension and the distance was record at this time,which was the tensile strength and length of the esophagogastric anas-tomosis.Results There was no significant difference in the tensile strength of the anastomotic site between the 30° group and the 45° group in the light,medium,and heavy weight blocks(F=0.27,0.82,0.91,P＞0.05).However,compared with the 30° and 45° groups in each block,the tensile strength of the anastomotic site decreased in the 0° group(P＜0.05).Excluding block factors,the tensile strength of the oblique conformal anastomosis group was greater than that of the conventional 0° anastomosis group(F=40.86,P＜0.05).The traction distance at which anastomotic leakage occurred in the oblique conformal anastomosis group was greater than that in the conventional 0° anastomosis group(F=12.20,P＜0.05).Conclusion Oblique conformal anastomosis is simple to perform,which can increase the tensile strength of anastomosis and significantly reduce the risk of esophagogastric anastomotic leakage in pigs.关键词
食管肿瘤/吻合口漏/吻合口张力/吻合口抗拉强度/倾斜适形吻合/吻合方法Key words
esophageal neoplasms/anastomotic leakage/tension of anastomotic stoma/anastomotic tensile strength/oblique conformal anastomosis/methods of anastomosis引用本文复制引用
郭金洋,徐延昭,黄超,田子强..倾斜适形吻合对提高猪食管胃吻合口抗拉强度的作用[J].中国现代手术学杂志,2025,29(2):87-91,5.基金项目
河北省医学科学研究课题计划(20250882) （20250882）
