Comparison of Pressure Resistances of Different Esophagogastric Anastomosis Techniques: An Ex Vivo Ovine Model Study

Authors : Duygu MERGAN İLİKLERDEN, Ümit Haluk İLİKLERDEN, Ozan OKYAY, İbrahim ÖZALP, Orhan BEGER, Serhat BİNİCİ, Burhan BEGER, Caner KAYIKCI

Pages : 1-8

Doi:10.52976/vansaglik.1040145

View : 20 | Download : 7

Publication Date : 2023-04-30

Article Type : Research Paper

Abstract :Background: Current anastomosis techniques including conventional esophageal insert ignore into journalissuearticles values(CEAT); and region expanding anastomosis techniques insert ignore into journalissuearticles values(REAT); in esophagus cancer surgeries have high mortality and morbidity rates, which underlines the lack of a golden standard method. Anastomosis techniques are one of responsible factors for stricture formation. In this regard, the study conducted on ex vivo ovine tissues was aimed to compare pressure resistances of different anastomosis techniques in term of stricture formation. Methods: Thirty-five esophagus and gastric samples from 35 male lambs aged 12 months were used ex vivo for the study. Samples were divided into 5 groups according to anastomosis techniques including Hand-Made Sutured Technique insert ignore into journalissuearticles values(HM);, Circular Stapler Sutured Technique insert ignore into journalissuearticles values(CS);, Reinforced Circular Stapler Sutured Technique insert ignore into journalissuearticles values(rCS);, Modified Plus “+” Incision Technique insert ignore into journalissuearticles values(mP+IT);, and Modified Arrow-Bow Hand-Made Sutured Technique insert ignore into journalissuearticles values(mabHM);. The intraluminal pressure resistance of the CEAT insert ignore into journalissuearticles values(e.g. the HM, CS and rCS); and REAT insert ignore into journalissuearticles values(e.g. the mP+IT and mabHM); were recorded. Results: The pressures of different incision techniques from the highest to the lowest were found as follows: the rCS insert ignore into journalissuearticles values(114.71±3.77 cm H2O); > the CS insert ignore into journalissuearticles values(95.43±3.45 cm H2O); > the HM insert ignore into journalissuearticles values(84.14±3.67cm H2O); > the mabHM insert ignore into journalissuearticles values(79.71±2.87 cm H2O); > the mP+IT insert ignore into journalissuearticles values(77.14±6.23 cm H2O); insert ignore into journalissuearticles values(p < 0.001);. Except the comparison of the HM versus the mabHM insert ignore into journalissuearticles values(p=0.558);, and the mP+IT versus the mabHM, the other techniques differ statistically significantly from each other. Conclusion: In our study, the durability of anastomoses using CEAT was found to be higher and compatible with the literature. Although in vivo live animal studies are necessary, REAT can be safely used to prevent the development of stricture, which is the second most common complication of esophagogastric anastomoses. Our findings suggest that the CEAT especially the rCS can be safely administered to prevent leakage.
Keywords : esophagogastric anastomosis, stricture, surgical techniques, esophagus, stomach