Comparison of postoperative motility in hand-sewn end-to-end anastomosis and functional end-to-end anastomosis: an experimental study in conscious dogs.
OBJECTIVE
The objective of this study is to compare the postoperative motility between hand-sewn end-to-end anastomosis and functional end-to-end anastomosis.


METHODS
Fifteen conscious dogs were divided into three groups: normal intact dog group, end-to-end anastomosis group (EE), and functional end-to-end anastomosis group (FEE). In the EE and FEE groups, the dogs underwent a transection of the jejunum 30 cm distal to the Treitz ligament and anastomosis in each method. To compare the gastrointestinal motility, the time to the appearance and the rate of propagation of interdigestive migrating motor contractions (IMC) across the anastomosis, as well as the motility index (MI) at the oral and anal sides of the anastomosis, were measured using strain gauge force transducers. Furthermore, the histological examination of intrinsic nerve fibers was evaluated.


RESULTS
The time to the appearance of propagation of IMC in the EE and FEE was not significantly different. The propagation rates of IMC in the EE and FEE completely recovered within 4 weeks of the surgery. The MI in the EE and FEE was not significantly different. In addition, no continuity of intrinsic nerve fibers across the anastomosis could be identified in either group.


CONCLUSIONS
In the present study, there are no significant differences between the EE and FEE with regard to the time of the appearance and the rate of propagation of IMC. These results suggest that the effect of functional end-to-end anastomosis on postoperative motility is not different from that of hand-sewn end-to-end anastomosis.
Toyomasu
Yoshitaka
Y
Department of General Surgical Science (Surgery I), Gunma University Graduate School of Medicine, 3-39-22 Showa-Machi, Maebashi, Gunma, 371-8511, Japan. toyomasu@med.gunma-u.ac.jp
Mochiki
Erito
E
Ando
Hiroyuki
H
Yanai
Mitsuhiro
M
Ogata
Kyoichi
K
Tabe
Yuichi
Y
Ohno
Tetsuro
T
Aihara
Ryuusuke
R
Kuwano
Hiroyuki
H
D000714:Anastomosis, Surgical; D000818:Animals; D003243:Consciousness; D004285:Dogs; D017615:Enteric Nervous System / Q000503:physiopathology; D005260:Female; D005769:Gastrointestinal Motility; D007583:Jejunum / Q000294:innervation / Q000503:physiopathology / Q000601:surgery*; D010535:Laparoscopy / Q000009:adverse effects; D008297:Male; D016065:Myoelectric Complex, Migrating; D011312:Pressure; D020127:Recovery of Function; D013536:Suture Techniques / Q000009:adverse effects; D013997:Time Factors; D014160:Transducers, Pressure; D016896:Treatment Outcome; D014945:Wound Healing