[Terminolateral esophagojejunostomy after gastrectomy with the biofragmentable anastomosis ring in the dog model].
BACKGROUND
Esophagojejunostomy after total gastrectomy still remains a high risk anastomosis with a considerable morbidity and mortality. The majority of these anastomoses are performed by the intraluminal stapler technique, yet stenoses are a known late complication even after an uneventful postoperative course. In the present study, the osophagojejunostomy with the biofragmentable anastomosis ring (BAR) was examined in dogs.


METHODS
28 dogs were randomized into a group of manual suture (n = 14) and a BAR-group (n = 14). After gastrectomy, the esophagojejunostomy was performed by hand-suture with polypropylene 4-0 in the manual suture group, and with the 25/1.5 mm BAR in the BAR-group. In both groups the Roux-en-Y jejunojejunostomy was performed by hand-suture. The dogs were evaluated on postoperative days 4, 7 and 14 with regard to macroscopy, bursting strength, tissue hydroxyproline and histology.


RESULTS
There was one leakage without clinical effect in the hand-sewn group on postoperative day 4; there was no leak in the BAR-group. In observing fibre-free enteral feeding, neither functional disorders nor obstruction of the BAR were observed. The general anastomosis parameters were matchable between the groups.


CONCLUSIONS
The infracarinal BAR-esophagojejunostomy is comparable to the hand-sewn anastomosis in the dog-model.
Dietz
U A
UA
Universitätsklinikum Würzburg, Chirurgische Klinik I, 97080 Würzburg. Dietz_U@chirurgie.uni-wuerzburg.de
Araújo
A C F
AC
Czeczko
N G
NG
Lemos
R
R
Araújo
U
U
Inácio
C M
CM
Salles
G
G
Corrêa Neto
M
M
Repka
J C D
JC
Zanellato
C M F
CM
Malafaia
O
O
Debus
E S
ES
Thiede
A
A
D000714:Anastomosis, Surgical / Q000295:instrumentation*; D000818:Animals; D004285:Dogs; D004386:Duodenum / Q000601:surgery*; D004947:Esophagus / Q000601:surgery*; D005743:Gastrectomy; D006801:Humans; D006909:Hydroxyproline / Q000378:metabolism; D019736:Prostheses and Implants; D013536:Suture Techniques / Q000295:instrumentation*; D016896:Treatment Outcome; D014945:Wound Healing / Q000502:physiology
D006909:Hydroxyproline