Morphogenesis Characteristics of Experimental Intestinal Anastomoses Made by Microsurgical Technique

ORIGINAL ARTICLE
Pavel A. Rezanov, Serhiy H. Hryvenko, Igor V. Kaminsky, Fedor N. Ilchenko, Yuriy V. Artemov, Evelina R. Kondratiuk

 
International Journal of Biomedicine. 2019;9(3):242-246.   
DOI: 10.21103/Article9(3)_OA11
Originally published September 15, 2019  

Abstract: 

This article presents the results of morphologic examination of intestinal anastomoses (IAs) formed by a precision technique in an experiment. Processes of regeneration in the zone of bowel anastomoses made with the author's precision one-row continuous suture (POCS) (Ukraine patent UA 32940), the author's precision one-row interrupted suture (POIS) (Ukraine patent UA 119073) and a double-row Albert—Schmieden suture (DASS) on rabbits of butterfly breed (n=45) are reviewed. Histological examination on Days 1, 3, 5, 14 and 30 revealed differences in reparative processes depending on the type of anastomoses. The morphological pattern in the early term (Day 3) of reparation is caused by the predominance of lysis of collagen fibers; nevertheless, in the early term the quantitative evaluation of healing stages was higher in the two groups of precision anastomoses than in the DASS group (2.00±0.00 points vs. 1.33±0.33 points). Formation of granulation tissue and collagen started on Days 5-7 in the two groups of precision anastomoses versus Days 7-14 in the DASS group, and in the two groups the process reached Stage 5 of reparation (3.00±0.00 points), while in DASS group it reached only Stage 4 (1.67±0.33 points). There were differences in the quantitative evaluation of staging on Day 30. In Group 1 (POCS), it was 5.00±0.00 points in average while in Group 2 (POIS) it was insignificantly lower (4.67±0.33 points). Differences between healing stage criteria were statistically significant in the precision technique sutures versus DASS (P<0.05). We did not find a statistically significant difference in the healing process between the two types of anastomoses formed by the precision technique. In contrast to DASS, the precision technique sutures do not deform a bowel lumen. Thus, the use of microsurgical techniques is the preferred method for forming IA.

Keywords: 
intestinal sutures • intestinal anastomoses • precision technique
References: 
  1. Astapenko VV, Zareckij SV, Markovskij AG, Hmara DV. Experience in the use of latex tissue glue for abdominal surgery. Meditsinskaya Panorama [Internet]. 2011;4. Available from: http://www.bsmu.by/files/fa4dce7113e3e2844391ac34e73b68d9/ [Article in Russian].
  2. Hryvenko SG, Rezanov PA. The results of applying single – and double-layered  sutures in the formation of anastomoses in abdominal surgery. Kharkov School of Surgery. 2014; 6(69):13-16. [Article in Russian].
  3. Podpriatov SS, Podpryatov SE, Gichka SG, Makarov AV, Marinsky GS, Tkachenko VA, et al.  Clinical and morphological features of multi-point and linear colon electrically welded anastomosis. Hospital Surgery. Journal named by L.Ya. Kovalchuk. 2018; 3:50-56. doi.10.11603/2414-4533.2018.3.9229  [Article in Ukrainian].
  4. Neutzling CB, Lustosa SA, Proenca IM, da Silva EM, Matos D. Stapled versus handsewn methods for colorectal anastomosis surgery. Cochrane Database Syst Rev. 2012;(2):CD003144. doi: 10.1002/14651858.CD003144.pub2.
  5. de Hingh IH, de Man BM, Lomme RM, van Goor H, Hendriks T. Colonic anastomotic strength and matrix metalloproteinase activity in an experimental model of bacterial peritonitis. Br J Surg. 2003 Aug;90(8):981-988. doi.org/10.1002/bjs.4146
  6. Ballantyne GH. Intestinal suturing. Review of the experimental foundations for traditional doctrines. Dis Colon Rectum. 1983;26(12):836-43.
  7. Pasic F, Salkic NN. Predictive score for anastomotic leakage after elective colorectal cancer surgery: a decision making tool for choice of protective measures. Surg Endosc. 2013;27(10):3877-82. doi: 10.1007/s00464-013-2997-1.
  8. Ho Y-H, Ashour MAT. Techniques for colorectal anastomosis. World J Gastroenterol. 2010;16(13):1610–21.
  9. Ciman U. Experimental morphological assessment of new rigidly ligature sutures during gastric resections. Bulletin of Urgent and Recovery medicine . 2005; 6(4):663-668. [Article in Russian].
  10. Hryvenko SH, Rezanov PA. Single-layer intestinal anastomosis formation option: operational experience. Svіt medicini ta bіologії. 2015; 1(48):21-23. [Article in Russian].
  11. Antipov NV. Strukturnye izmeneniya v zone gastroduodenal'nogo anastomoza s primeneniem novogo metoda adaptiruyushchego shva. Ukraїns'kij morfologіchnij al'manah. 2011; 9(3):19-21. [Article in Russian].
  12. Rezanov PA, Kaminsky IV, inventors; Crimean State Medical University, assignee. The method for formation of the anastomosis of the gastrointestinal tract. (Ukraine patent UA 32940. 2008 June 11. [in Ukrainian].
  13. Rezanov PA, Hryvenko SH, inventors; Rezanov PA, Hryvenko SH, assignees. The method for formation of the anastomosis of the gastrointestinal tract. Ukraine patent UA 119073. 2017 September 17. [in Ukrainian].
  14. Cetinkaya Z, Esen K, Ozercan IH, Ustundag B, Ayten R, Aygen E. The effect of Bosentan on healing of colonic anastomosis. World J Emerg Surg. 2006;1:37.

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Received June 5, 2019.
Accepted August 1, 2019.
©2019 International Medical Research and Development Corporation.