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THE JOURNAL OF CARDIOVASCULAR SURGERY
Rivista di Chirurgia Cardiaca, Vascolare e Toracica
Indexed/Abstracted in: BIOSIS Previews, Current Contents/Clinical Medicine, EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
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ORIGINAL ARTICLES THORACIC SECTION
The Journal of Cardiovascular Surgery 2003 December;44(6):775-8
The effect of tension on esophagogastric anastomotic wound healing in rats
Cui Y. 1,2, Chen H. 2
1 Department of Thoracic Surgery, Roswell Park Cancer Institute, Buffalo, NY, USA
2 Department of Thoracic Surgery, First Hospital, Beijing University, Beijing, China
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Aim. The effect of tension on the occurrence of esophagogastric anastomotic leaks has been controversial for a long time. We used a rat model and investigated the effect of tension on the esophagogastric anastomotic wound healing.
Methods. Eighty Sprague-Dawley rats were divided into 8 groups and each group has 10 rats. A side-to-side single layer esophagogastric anastomosis was constructed using interrupted sutures through laparotomy. Anastomoses were excised on day 0, 3, 5, 7, 14, mounted in an Instron mini-44 Tensionmeter and distracted at 10 mm/min to measure breaking strength. On the other hand, the increased anastomotic tensions were obtained by increasing the distance between esophageal incision and gastrotomy, and anastomotic leak rates in different anastomotic tension groups were investigated.
Results. A total of 11 rats were excluded from the studies because of pulmonary complication. Breaking strength on day 0, 3, 5, 7, 14 were 3.35±0.89, 1.18±0.31, 1.92±0.46, 3.47±0.83, 5.06±1.22 (Newton), respectively. The breaking strength is significantly different between day 0 and day 3, day 5 and day 7, day 7 and day 14 (p<0.05). There is no difference between day 3 and day 5, day 0 and day 7 (p>0.05). Breaking strength is lowest on day 3 and close to culmination on day 14. Esophagogastric anastomotic leaks increased along with anastomotic tension increasing.
Conclusion. Anastomotic tension could be a key factor resulting in esophagogastric anastomotic leaks.