Akademik Veri Yönetim Sistemi
Van Sağlık Bilimleri Dergisi, cilt.16, sa.1, ss.1-8, 2023 (Hakemli Dergi)
Background: Current anastomosis techniques including conventional
esophageal (CEAT) and region expanding anastomosis techniques (REAT) in
esophagus cancer surgeries have high mortality and morbidity rates,
which underlines the lack of a golden standard method. Anastomosis
techniques are one of responsible factors for stricture formation. In
this regard, the study conducted on ex vivo ovine tissues was aimed to
compare pressure resistances of different anastomosis techniques in term
of stricture formation.
Methods: Thirty-five esophagus and gastric samples from 35 male lambs
aged 12 months were used ex vivo for the study. Samples were divided
into 5 groups according to anastomosis techniques including Hand-Made
Sutured Technique (HM), Circular Stapler Sutured Technique (CS),
Reinforced Circular Stapler Sutured Technique (rCS), Modified Plus “+”
Incision Technique (mP+IT), and Modified Arrow-Bow Hand-Made Sutured
Technique (mabHM). The intraluminal pressure resistance of the CEAT
(e.g. the HM, CS and rCS) and REAT (e.g. the mP+IT and mabHM) were
recorded.
Results: The pressures of different incision techniques from the highest
to the lowest were found as follows: the rCS (114.71±3.77 cm H2O) >
the CS (95.43±3.45 cm H2O) > the HM (84.14±3.67cm H2O) > the mabHM
(79.71±2.87 cm H2O) > the mP+IT (77.14±6.23 cm H2O) (p < 0.001).
Except the comparison of the HM versus the mabHM (p=0.558), and the
mP+IT versus the mabHM, the other techniques differ statistically
significantly from each other.
Conclusion: In our study, the durability of anastomoses using CEAT was
found to be higher and compatible with the literature. Although in vivo
live animal studies are necessary, REAT can be safely used to prevent
the development of stricture, which is the second most common
complication of esophagogastric anastomoses. Our findings suggest that
the CEAT especially the rCS can be safely administered to prevent
leakage.