消化管器械吻合後の吻合部狭窄に関する実験的研究

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  • <Originals>Experimental study on stenosis after instrumental anastomosis in canine colon

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Anastomotic stenosis was performed with an EEA stapler or an AKA sutureless compression device in the colon of dogs with or without fecal passage. A colonic segment about 10 cm long was resected, with its blood supply preserved. In the center of the resected segment, EEA stapling anastomosis was performed in 7 dogs and AKA compression anastomosis in another 6 dogs. The proximal end of this segment was closed and a colostomy was made at the distal end. One month after the operation, the animals were killed and the index of stenosis was calculated using barium roentgenography. Also histologic evaluation was performed. The index of stenosis was significantly higher for EEA anastomoses compared with AKA anastomoses, p<0.05. Histologic investigation showed more complete epithelization and better tissue alignment in AKA anastomoses. In conclusion, the EEA stapler seems to predispose to stricture formation especially when the anastomotic site is excluded from fecal passage and the AKA compression device appears to have the potential to lower the risk of anastomotic stenosis in the colon.

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