Endoscopy and autopsy follow-up of biodegradable oesophageal anastomoses in dogs.
The biofragmentable Anastomosis Ring (BAR) is a mechanical device composed of absorbable material and creates an inverting, atraumatic compressive anastomosis with no foreign material at the anastomotic site after healing. The aim of the present experimental study was to assess the safety of oesophagoscopy in early days after oesophageal anastomoses performed with the BAR and to follow-up the healing of BAR anastomoses by in vivo endoscopy and autopsy examination. Thirty mongrel dogs divided into subgroups according to the time-points of endoscopy and autopsy (4th, 7th, 14th, 28th day) were used. There was no significant difference in the healing of anastomoses performed under or above the tracheal bifurcation. Pleural adhesions helped to cover and seal small subclinical leaks. The mortality was 13.3% (4 dogs) and the overall leakage rate 14.3%. We looked for bleeding, haematoma, erosion, ulceration and granulation tissue in the anastomosis. Due to the high mechanical strength of these anastomoses, oesophagoscopy was a safe, easy and feasible method for follow-up BAR intrathoracic anastomoses, with no significant difference between the number of lesions found with endoscopy as compared to the autopsy data. The overall sensitivity of oesophagoscopy to discover mucosal lesions was 73.1%. Endoscopy had no complications, therefore it is a useful method of follow-up and may help predict the normal or compromised healing of oesophageal anastomoses.
Kovács
T
T
Department of General and Thoracic Surgery, National Institute of Oncology, H-1122 Budapest, Ráth Gy. u. 7-9, Hungary. kovacsti@oncol.hu
Németh
T
T
Orosz
Z
Z
Köves
I
I
D020341:Absorbable Implants; D000714:Anastomosis, Surgical / Q000295:instrumentation* / Q000401:mortality*; D000818:Animals; D001344:Autopsy; D004285:Dogs; D004867:Equipment Design; D004940:Esophageal Stenosis / Q000601:surgery; D004945:Esophagoscopy / Q000009:adverse effects / Q000592:standards*; D005500:Follow-Up Studies; D023421:Models, Animal; D012680:Sensitivity and Specificity; D013529:Surgical Wound Dehiscence / Q000209:etiology; D014945:Wound Healing