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©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
Magnetic compression anastomosis for reconstruction of digestive tract after total gastrectomy in beagle model
Miao-Miao Zhang, Chen-Guang Li, Shu-Qin Xu, Jian-Qi Mao, Yu-Han Zhang, Ai-Hua Shi, Yan Li, Yi Lyu, Xiao-Peng Yan
Miao-Miao Zhang, Shu-Qin Xu, Yi Lyu, Xiao-Peng Yan, Department of Hepatobiliary Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, Shaanxi Province, China
Miao-Miao Zhang, Shu-Qin Xu, Ai-Hua Shi, Yan Li, Yi Lyu, Xiao-Peng Yan, National Local Joint Engineering Research Center for Precision Surgery & Regenerative Medicine, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, Shaanxi Province, China
Chen-Guang Li, Department of Critical Care Medicine, China-Japan Union Hospital of Jilin University, Changchun 130000, Jilin Province, China
Jian-Qi Mao, Zonglian College, Xi'an Jiaotong University, Xi'an 710061, Shaanxi Province, China
Yu-Han Zhang, Qide College, Xi'an Jiaotong University, Xi'an 710061, Shaanxi Province, China
Author contributions: Lyu Y and Yan XP designed and coordinated the study; Zhang MM, Li CG, Xu SQ, Mao JQ, Zhang YH, and Yan XP performed the research and acquired the data; Zhang MM, Li CG, and Xu SQ analyzed the data; Shi AH, Li Y and Zhang MM tested and analyzed the magnetic force; Zhang MM, Li CG, and Yan XP wrote the manuscript; Yan XP and Lyu Y conceived of the study and contributed to the study design, the interpretation of the results, and the critical revision of the manuscript; All authors read and approved the final manuscript.
Supported by the Institutional Foundation of The First Affiliated Hospital of Xi’an Jiaotong University, No. 2022MS-07 (to Yan XP); and Key Research and Development Plan of Shaanxi Province, No. 2021GXLH-Z-009 (to Li Y).
Institutional animal care and use committee statement: The study protocol and all experimental procedures were carried out strictly in accordance with the Guidelines for Care and Use of Experimental Animals issued by the Xi’an Jiaotong University Medical Center. This experimental study was approved by the Experimental Ethics Committee of Xi’an Jiaotong University, No. 2022-1451.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: The authors declare that the data supporting the findings of this study are available within the article or from the corresponding authors upon request at
yanxiaopeng9966@163.com.
ARRIVE guidelines statement: The authors have read the ARRIVE Guidelines, and the manuscript was prepared and revised according to the ARRIVE Guidelines.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
https://creativecommons.org/Licenses/by-nc/4.0/ Corresponding author: Xiao-Peng Yan, MD, PhD, Associate Research Scientist, Department of Hepatobiliary Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, No. 277 West Yanta Road, Xi'an 710061, Shaanxi Province, China.
yanxiaopeng9966@163.com
Received: January 21, 2023
Peer-review started: January 21, 2023
First decision: April 13, 2023
Revised: April 17, 2023
Accepted: May 8, 2023
Article in press: May 8, 2023
Published online: July 27, 2023
Processing time: 180 Days and 21.8 Hours
BACKGROUND
Magnetic compression anastomosis (MCA) is a simple procedure contributing to a reliable anastomosis. However, digestive-tract reconstruction after total gastrectomy using MCA has not yet been reported.
AIM
To investigate the feasibility of MCA for simultaneous esophagojejunostomy and jejunojejunostomy after total gastrectomy using beagle dogs.
METHODS
Sixteen beagles were randomly divided into an MCA group (study group, n = 8) and a manual-suture anastomosis group (control group, n = 8). Two different magnetic anastomosis devices were used in the study group for esophagojejunal and jejunojejunal anastomoses. Both devices included a pair of circular daughter and parent magnets each. The time of esophagojejunostomy and jejunojejunostomy, postoperative complications, and survival rate of the two groups were compared. The dogs were sacrificed one month after the operation and their anastomotic specimens were obtained. Healing was observed by the naked eye and a light microscope.
RESULTS
Digestive-tract reconstruction after total gastrectomy was successfully completed in both groups (survival rate = 100%). In the study group, esophagojejunal and jejunojejunal anastomoses took 6.13 ± 0.58 and 4.06 ± 0.42 min, respectively, significantly lower than those in the control group (15.63 ± 1.53 min, P < 0.001 and 10.31 ± 1.07 min, P < 0.001, respectively). Complications such as bleeding, anastomotic leakage, and anastomotic stenosis were not observed. In the study group, the magnets did not interfere with each other. Discharge time of the jejunojejunal magnetic anastomosis device was 10.75 ± 1.28 d, while that of the esophagojejunal magnetic anastomosis device was 12.25 ± 1.49 d. Residual silk was found in the control group. The study group showed a greater smoothness of the anastomosis than that of the control group. All layers of anastomosis healed well in both groups.
CONCLUSION
MCA is a safe and feasible procedure for digestive-tract reconstruction after total gastrectomy in this animal model.
Core Tip: Magnetic compression anastomosis (MCA) is a new type of anastomosis and a simple procedure affording a reliable anastomosis effect. We proposed the application of MCA in digestive tract reconstruction after total gastrectomy in dogs, and set up a control group to compare with manual suture anastomosis. The results showed that MCA was superior to manual suture anastomosis in anastomosis time and anastomosis effect. Further optimization of magnet design and surgical methods can make it have clinical application prospects.
