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首页> 美国卫生研究院文献>International Journal of Clinical and Experimental Medicine >A novel sutureless colonic anastomosis with self-gripping mesh: an experimental model
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A novel sutureless colonic anastomosis with self-gripping mesh: an experimental model

机译：一种新型的具有自握网的无缝合结肠吻合术：实验模型

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Introduction: Anastomotic leakage is one of the most feared complications of colorectal surgery. High morbidity and mortality rates are related to this complication and several studies had been performed to test new techniques which are suggested to reduce leakage rates. The aim of our study was to evaluate the safety and effectiveness of a novel technique sutureless anastomosis with self-gripping mesh in an animal model by examining wound healing process in anastomosis. Methods: In this study sixteen Norwegian Wistar Albino female rats were used. The rats’ weights ranged from 250 to 300 g. The rats were divided into control and study groups. The control group underwent a colocolic anastomosis using the conventional method of hand-sewing with single-layer interrupted nonabsorbable sutures. The study group underwent a colocolic anastomosis using self-gripping mesh without sutures. These rats were sacrificed on the 10th postoperative day. The sample pieces obtained from the groups were subjected to anastomotic bursting pressure tests, to a test for hydroxyproline levels in the tissue and to histopathological examinations. The tissue was evaluated in terms of quantity of inflammatory cells, fibroblasts, neovascularization level and collagen content and classified according to the Ehrlich-Hunt model. Statistical analysis was done by using Mann-Whitney U test. Results: The burst pressure mean ± range of control and study groups were 162 ± 78 and 123 ± 35, respectively (P = 0.049). The mean peritoneal adhesion grades were 3.2 ± 0.7 in the study group and 2.3 ± 0.7 in the control group (P = 0.036). The operative time was significantly shorter in the study group. The difference between the groups by mean of hydroxyproline levels was found to be significant (P = 0.001). According to histopathological examinations by means of the Ehrlich-Hunt model, the fibroblast activation and collagen fiber ratio were higher in the study group and the difference between these measurements was statistically significant (P = 0.006; P = 0.028). Conclusion: This study showed that use of self-gripping meshes for colocolic anastomosis in rats is a safe and feasible method. It is suggested that the most important advantage of this technique is the shorter operative time.
机译：简介：吻合口漏是结直肠手术最令人担忧的并发症之一。高发病率和高死亡率与这种并发症有关，已经进行了数项研究以测试新技术，这些新技术可降低泄漏率。我们的研究目的是通过检查吻合术中的伤口愈合过程来评估一种新技术的自握网状无缝线吻合术的安全性和有效性。方法：在本研究中，使用了16只挪威Wistar Albino雌性大鼠。老鼠的体重在250至300克之间。将大鼠分为对照组和研究组。对照组采用常规手工缝制单层间断不可吸收缝线进行大肠吻合术。研究小组使用无缝线的自握网进行了大肠吻合术。在术后第10天处死这些大鼠。对从各组获得的样品片进行吻合口破裂压力测试，组织中羟脯氨酸水平的测试以及组织病理学检查。根据炎性细胞的数量，成纤维细胞，新血管形成水平和胶原蛋白含量评估组织，并根据Ehrlich-Hunt模型进行分类。使用Mann-Whitney U检验进行统计分析。结果：对照组和研究组的破裂压力平均值±范围分别为162±78和123±35（P = 0.049）。研究组的平均腹膜粘连等级为3.2±0.7，对照组为2.3±0.7（P = 0.036）。研究组的手术时间明显缩短。发现两组之间通过羟脯氨酸水平的差异是显着的（P = 0.001）。根据通过Ehrlich-Hunt模型进行的组织病理学检查，研究组的成纤维细胞活化和胶原纤维比率更高，并且这些测量值之间的差异具有统计学意义（P = 0.006； P = 0.028）。结论：这项研究表明，使用自握式网眼进行大肠吻合是一种安全可行的方法。建议该技术最重要的优点是手术时间更短。

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