Published online Sep 28, 2022. doi: 10.3748/wjg.v28.i36.5313
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
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.
There are several case reports of using MCA to treat esophageal stenosis. However, systematic animal experimental studies are scarce. This has restricted further clinical application of MCA.
This study was conducted to demonstrate the feasibility and safety of MCA for esophageal reconstruction and studied the difference between MCA and hand-sewn esophageal reconstruction.
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 sutures. The anastomosis time, gross appearance, weight and pathology of the anastomosis were evaluated at one month, three months and six months postoperatively.
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 (13.75 ± 0.84 kg vs 14.03 ± 0.82 kg, 14.93 ± 0.80 kg vs 15.44 ± 0.47 kg). Under an optical microscope, the number of inflammatory cells in MCA group was lower than that in hand-sewn group on 1 mo after operation.
MCA is an effective and safe method for esophageal reconstruction. The anastomosis time of the MCA 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.
MCA for esophageal reconstruction in the thoracic cavity needs to be tested, and further clinical trials are needed to test its safety and guide its clinical application.