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The Journal of Cardiovascular Surgery 1999 August;40(4):613-4

Copyright © 2000 EDIZIONI MINERVA MEDICA

lingua: Inglese

Comparison of anastomotic suturing techniques in the rat esophagus

Cui Y., Urschel J. D.

From the Department of Surgery Roswell Park Cancer Institute and State University of New York at Buffalo Buffalo, New York, USA


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Background. Long-gap esoph­a­geal atre­sia con­tin­ues to be a chal­leng­ing pedi­at­ric tho­rac­ic sur­gi­cal prob­lem. Despite the use of var­i­ous ten­sion reliev­ing pro­ce­dures, the esoph­a­geal anas­tom­o­sis is ­often per­formed ­under con­sid­er­able ten­sion. Excessive ten­sion can ­cause anas­to­mot­ic ­sutures to ­pull ­through the esoph­a­geal tis­sue, ­with resul­tant ear­ly esoph­a­geal anas­to­mot­ic dehis­cence. To ­test the hypoth­e­sis ­that inter­rupt­ed hor­i­zon­tal mat­tress ­sutures ­would with­stand the forc­es of ten­sion bet­ter ­than inter­rupt­ed sim­ple ­sutures, an experi­men­tal ­study of rat esoph­a­geal anas­to­mos­es was ­done.
Methods. Twenty ­rats ­were ­killed and ­their esoph­a­gi ­were ­excised. The esoph­a­gi ­were divid­ed in the mid por­tion and end-to-end anas­to­mos­es ­were ­done ­using inter­rupt­ed 6-0 poly­pro­py­lene ­sutures. Ten ­rats had anas­to­mos­es ­done ­with inter­rupt­ed sim­ple ­sutures and ten had inter­rupt­ed hor­i­zon­tal mat­tress sutur­ing. Anastomotic break­ing ­strength was test­ed in a ten­sio­me­ter.
Results. Anastomotic break­ing ­strength was 3.22±0.56 N for the inter­rupt­ed sim­ple ­sutured anas­to­mos­es and 3.51±0.61 N for the inter­rupt­ed hor­i­zon­tal mat­tress ­group (p=0.30). The dif­fer­ence was not sig­nif­i­cant.
Conclusions. In ­this ani­mal ­study inter­rupt­ed sim­ple and hor­i­zon­tal mat­tress sutur­ing with­stood the dis­rup­tive forc­es of anas­to­mot­ic ten­sion equal­ly ­well.

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