Experimental examination of the healing process of telescopic esophageal anastomosis

Abstract

The basis of telescopic anastomosis is old, only the practical details of it have changed and improved. The telescopic anastomosis technique is successfully applied in our practice for reconstruction of gastrectomy and esophageal resection. The reason for this study was that data about the healing process of telescopic anastomosis had not been found in the literature. We used four groups of mongrel dogs for our experiments: Group A (n = 3) received 20 mm-long invaginations with a survival time of 7 days; Group B (n = 3) received 10 mm-long invaginations with a survival time of 21 days; Group C (n = 3) received 20 mm-long invaginations with a survival time of 21 days; Group D (n = 3) received 30 mm-long invaginations with a survival time of 21 days. At the end of the above survival times we removed the anastomosing area, measured the bursting pressures and performed morphological and histological examinations. In each case we also performed an anastomosis exactly the same as a completely healed anastomosis and its pressure tolerance was measured (0 day). The pressure tolerance within the anastomosis rises gradually and independently of the length of the invaginated esophageal part. Anastomosis leakage did not occur. The invaginated esophageal part did not suffer any damage. The muscular wall of the intragastric part of the esophagus became covered by the mucosa of the stomach during the healing process and it joined with the esophageal mucosa at the edge of the free end of the esophagus.

A Comparison of the Postoperative Outcomes Between Intraoperative Leak Testing and Non-Intraoperative Leak Testing for Gastric Cancer Surgery: A Systematic Review and Meta-analysis

“…Excessive perfusion pressure can lead to insu cient blood perfusion, inadequate oxygen supply, and an increased risk of postoperative obstruction, dyspnea, and anastomotic rupture (23). The anastomotic blasting pressure wascarried out in animals and in vitro experiments (33)(34)(35). One experimental study showed that the colorectal anastomosis can be ruptured at 70-184 mmHg pressure, which demonstrates that there was a risk of rupture when 400ml liquid was injected (35).…”

“…The anastomotic blasting pressure wascarried out in animals and in vitro experiments (33)(34)(35). One experimental study showed that the colorectal anastomosis can be ruptured at 70-184 mmHg pressure, which demonstrates that there was a risk of rupture when 400ml liquid was injected (35). Anastomotic pressure monitoring is thus recommended for IOLT.…”