Basic Study
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Sep 28, 2022; 28(36): 5313-5323
Published online Sep 28, 2022. doi: 10.3748/wjg.v28.i36.5313
Esophageal magnetic compression anastomosis in dogs
Xiang-Hua Xu, Yi Lv, Shi-Qi Liu, Xiao-Hai Cui, Rui-Yang Suo
Xiang-Hua Xu, Yi Lv, Department of Hepatobiliary Surgery, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an 710061, Shaanxi Province, China
Xiang-Hua Xu, Yi Lv, National Local Joint Engineering Research Center for Precision Surgery and Regenerative Medicine, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an 710061, Shaanxi Province, China
Shi-Qi Liu, Department of Pediatric Surgery, Xi’an Children’s Hospital, Xi’an 710003, Shaanxi Province, China
Xiao-Hai Cui, Department of Thoracic Surgery, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an 710061, Shaanxi Province, China
Rui-Yang Suo, Zonglian College, Xi’an Jiaotong University Health Science Center, Xi’an 710061, Shaanxi Province, China
Author contributions: Xu XH, Liu SQ, Lv Y designed and coordinated the study; Xu XH, Liu SQ, Cui XH and Suo RY performed the experiments and acquired and analyzed the data; XH Xu and Lv Y wrote the manuscript; and all authors approved the final version of the article.
Supported by the National Natural Science Foundation of China, No. 82170676; and Natural Science Foundation of Shaanxi Provincial Key Industries Innovation Chain (Cluster)-Social Development Project, No. 2020ZDLSF02-03.
Institutional animal care and use committee statement: All experimental protocols were approved by the Committee on the Ethics of Animal Experiments of Xi’an Jiaotong University (Permit Number: XJTULAC2020-1441).
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: No additional data are available.
ARRIVE guidelines statement: The authors 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: Yi Lv, MD, PhD, Professor, Department of Hepatobiliary Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, No. 277 West Yanta Road, Xi'an 710061, Shaanxi Province, China. luyi169@126.com
Received: July 14, 2022
Peer-review started: July 14, 2022
First decision: July 31, 2022
Revised: August 11, 2022
Accepted: September 9, 2022
Article in press: September 9, 2022
Published online: September 28, 2022
Abstract
BACKGROUND

Magnetic compression anastomosis (MCA) is a novel suture-free reconstruction of the digestive tract. It has been used in gastrointestinal anastomosis, jejunal anastomosis, cholangioenteric anastomosis and so on. The traditional operative outcomes of congenital esophageal atresia and benign esophageal stricture are poor, and there are too many complications postoperatively.

AIM

To test MCA technology to reconstruct the esophagus in dogs, prior to studying the feasibility and safety of MCA in humans.

METHODS

Thirty-six dogs were randomized into either the study or control group (n = 18 per group). The dogs in the study group were subjected to end-to-end esophageal anastomosis with the magnetic compression device, while those in the control group underwent hand-sewn anastomosis with 4-0 absorbable multifilament Vicryl. We used interrupted single-layer inverting sutures. The anastomosis time, gross appearance, weight and pathology of the anastomosis were evaluated at one month, three months and six months postoperatively.

RESULTS

The anastomosis time of the MCA group was shorter than that of the hand-sewn group (7.5 ± 1.0 min vs 12.5 ± 1.8 min, P < 0.01). In the MCA group, X-ray examination was performed every day to locate the magnetic device in the esophagus before the magnetic device fell off from the esophagus. In the hand-sewn group, dogs did not undergo X-ray examination. One month after the surgeries, the mean weight of the dogs in the hand-sewn group had decreased more than that of the dogs in the MCA group (11.63 ± 0.71 kg vs 12.73 ± 0.80 kg, P < 0.05). At 3 mo and 6 mo after the operation, the dogs’ weights were similar between the two groups (13.75 ± 0.84 kg vs 14.03 ± 0.82 kg, 14.93 ± 0.80 kg vs 15.44 ± 0.47 kg). The number of inflammatory cells in MCA group was lower than that in hand-sewn group on 1 mo after operation.

CONCLUSION

MCA is an effective and safe method for esophageal reconstruction. The anastomosis time of the MCA group was less than that of the hand-sewn group. This study shows that MCA technology may be applied to human esophageal reconstruction, provided these favorable results are confirmed by more publications.

Keywords: Magnetic, Anastomosis, Esophagus, Reconstruction, Hand sewn, Dog

Core Tip: We used magnetic compression anastomosis (MCA) technology to reconstruct the esophagus. The anastomosis time of the MCA group was shorter than that of the hand-sewn group (7.5 ± 1.0 min vs 12.5 ± 1.8 min, P < 0.01). One month after the surgeries, the mean weight of the dogs in the hand-sewn group had decreased more than that of the dogs in the MCA group (11.63 ± 0.71 kg vs 12.73 ± 0.80 kg, P < 0.05). At 3 mo and 6 mo after the operation, the dogs’ weights were similar between the two groups. MCA is an effective and safe method for esophageal reconstruction. This study shows that MCA technology may be applied to human esophageal reconstruction, provided these favorable results are confirmed by more publications.