Comparison of anastomotic suturing techniques in the rat esophagus.
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.
Cui
Y
Y
Department of Surgery, Roswell Park Cancer Institute and State University of New York at Buffalo, USA.
Urschel
J D
JD
D000714:Anastomosis, Surgical / Q000379:methods*; D000818:Animals; D004933:Esophageal Atresia / Q000601:surgery; D004947:Esophagus / Q000601:surgery*; D006801:Humans; D007231:Infant, Newborn; D011126:Polypropylenes; D051381:Rats; D017207:Rats, Sprague-Dawley; D013536:Suture Techniques; D013537:Sutures; D013718:Tensile Strength
D011126:Polypropylenes