The Application of a Mechanical Side-to-Side Oesophagogastric Anastomosis in the Reconstruction of the Digestive Tract After an Oesophagectomy in a Beagle Model.

Abstract

OBJECTIVES: To investigate the application of a mechanical side-to-side oesophagogastric anastomosis in the reconstruction of the digestive tract of beagles after an oesophagectomy. METHODS: Eighteen beagles were randomly divided into 3 groups: the hand-sewn (HS) group, the linear-stapled anastomosis in the oesophagus and anterior portion of the stomach (LESA) group and the linear-stapled anastomosis in the oesophagus and the posterior portion of the stomach (LESP) group. The gastro-oesophageal reflux, anastomotic area, anastomotic bursting pressure and the breaking strength in the beagles at 1 week and 12 weeks after the operations were compared. The histopathological morphology was observed using haematoxylin-eosin staining and Masson staining, and the expression of the vascular endothelial growth factor (VEGF) was detected by immunohistochemical analysis. RESULTS: At 1 and 12 weeks after the operation, the percentage of gastro-oesophageal reflux time and the longest reflux time in the HS group and the LESP group were higher than those in the LESA group (P&#x2009;<&#x2009;.05). The anastomotic areas in the HS group were significantly smaller than those in the LESA and LESP groups at 1 and 12 weeks postoperatively (P&#x2009;<&#x2009;.05); there were no differences in the anastomotic areas in the LESA and LESP groups. At 1 and 12 weeks postoperatively, the bursting pressure and breaking strength of the anastomosis, the collagen-fibre area ratio and VEGF positive expression in the LESA group were significantly higher than those in the HS group (P&#x2009;<&#x2009;.05). CONCLUSIONS: The mechanical side-to-side oesophagogastric anastomosis of the oesophagus and the anterior wall of the stomach can reduce the occurrence of gastro-oesophageal reflux, increase the bursting pressure and breaking strength, promote collagen fibre and VEGF expression, to promote healing of the anastomosis.