An Elementary Trial Research For Small Bowel Anastomosis In A Rabbit Model By Using Stant

Take a wide view on the development of the surgery of alimentary tract. Anastomoses are the key point of reconstitution of the gastrointenstinal truct and are also the key point to the development of the surgery of alimentary tract. When some suitable anastomosis method has been found, it was lead to a quick development of this field. The suitable method mean a simple safe technique with lower postoperative complication and easy to learn. There are several methods for anastomosis of alimentary tract, such as suture, surgical stapler, laser welding, adhesive but all has its shortage. And we try to find a new method that is safe simple and inexpensive. We had this idea with the inspiration of stent used in vascular suture. Using a stent for small bowel anastomosis in a rabbit model may be safe and useful. Through our study, we hope to make a conclusion to the feasibility, the security and the reliability of small bowel anastomosis in a rabbit model by using a stent.Material and Methods Study objects40 healthy Zelanian rabbits, male, avoirdupois from 1.7 to 2.3kg (2.0 ± 0.3kg) , from laboratorial animals center, Zhejiang university school of medicine. Study groupsThrough randomized controlled method, study objects divide into laboratorial group, in which there are 25 habbits, and controlled group, in which there are 15 habbits. Study way1. Fasting for 24 hours before surgery.2. General anaesthesia by intraperitoneal injection of 8% chloral hydrateat 5ml / kg.3. Location in small bowel 25~40cm far from the proximal end, then transaction the bowel for anastomosis. Using a stent for anastomosis in laboratorial group, both broken ends of bowel embolia to the stent, and hypodesmus the bowel to the stent suture for anastomosis in controlled group.4. Haemostasis, and close the abdomen.5. Fasting 24 hours after operation, but drinking freely. After 24 hours, turn to normal diet.6. After 3 days, one week, two weeks of the operation, kill the rabbits,and then observe the anastomosis concrescence, any leakage or adhesion. Measure the inner perimeter of anastomosis margin, the inner perimeter ratio, and the blasting pressure. And also check the pathological section of the anastomosis margin.Statistical analysisAll data was processed with SPSS 13.0 software bag in personal computer. Values were expressed as mean+SD. All qualitative data was checked by Chi-Square test and quantitative data was checked by ANOVAtest.Result and Discussion1. Accomplishing time for anastomosis in laboratorial group (7.6 ± 2.2min min) was shorter than in controlled group (15.2±2.1min),(t=-10.564, P<0.01) .2. Anastomosis leakage ratio in laboratorial group was 16.0%, and in controlled group were 6.67%.Use Chi-Square test and no statistics difference (P>0.05).3. The mortality of the laboratorial group was 12.0%,and in controlled group was 13.3%. Use Chi-Square test and no statistics difference (P>0.05).4. The blasting pressure in anastomosis margin, after 3 days, was 3.06 + 0.91 Kpa in laboratorial group and 4.55 + 0.70 Kpa in controlled group,(P<0.05). One week, was 6.20+1.79 Kpa in laboratorial group and 8.37+1.82 Kpa in controlled group ,(P>0.05). Two weeks, was 13.27 + 2.01 Kpa in laboratorial group and 14.48+1.75 Kpa in controlled group ,(P>0.05). We think the use of stent in anastomosis is safe.5. The ratio between the inner perimeter of anastomosis margin and that of adjacent small bowel, after 3 days, one week, two weeks of the operation, were 0.96 + 0.06, 0.95 + 0.46, 0.90 + 0.10 in laboratorial group, and in controlled group were 0.84+0.05, 0.83+0.64, 0.76 + 0.09. Compare with the ratio between the inner perimeter of anastomosis margin and that of adjacent small bowel in controlled group, that in laboratorial group seemed smaller with remarkable statistics difference (P<0.05).6. The general and microscopic appearance of the anastomosis margin.3 days after operation, both had smooth adhesion in abdominal cavity. The anastomosis margin of the laboratorial group is smoother. Under microscopy, the laboratorial group had less inflammatory cell infiltration. 1 week after operation, almost no edema around anastomosis, under microscopy, both had inflammatory cell infiltration. 3 weeks after operation almost cannot found where is the anastomosis. Under microscopy, less inflammatory cell infiltration than before, and both can found fibrous tissue hyperplasia.Conclusion1. Using a stent for small bowel anastomosis in a rabbit model is safe and useful.2. This operation proved that this method is safe> simple and easy to grasp. And the inner perimeter ratio is bigger than the controlled group;it means lower risk of long-term complication of bowel obstruction.3. The key point now is to find a suitable stent.4. To evaluate the feasibility, the security and the reliability of smallbowel anastomosis in a rabbit model by using a stent, we think it affirmative. But it still is an elementary trial research, and needs more examples to prove.