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

doi:10.4240/wjgs.v15.i7.1294

Magnetic compression anastomosis for reconstruction of digestive tract after total gastrectomy in beagle model

World J Gastrointest Surg. 2023 Jul 27;15(7):1294-1303. doi: 10.4240/wjgs.v15.i7.1294.

Authors

Miao-Miao Zhang^{1

2}, Chen-Guang Li³, Shu-Qin Xu^{1

2}, Jian-Qi Mao⁴, Yu-Han Zhang⁵, Ai-Hua Shi², Yan Li², Yi Lyu^{1

2}, Xiao-Peng Yan^{1

6}

Affiliations

¹ Department of Hepatobiliary Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, Shaanxi Province, China.
² 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.
³ Department of Critical Care Medicine, China-Japan Union Hospital of Jilin University, Changchun 130000, Jilin Province, China.
⁴ Zonglian College, Xi'an Jiaotong University, Xi'an 710061, Shaanxi Province, China.
⁵ Qide College, Xi'an Jiaotong University, Xi'an 710061, Shaanxi Province, China.
⁶ 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. yanxiaopeng9966@163.com.

Abstract

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.

Keywords: Beagles; Gastric cancer; Magnetic compression anastomosis; Magnetic surgery; Roux-en-Y esophagojejunal anastomosis; Total gastrectomy.