Clinical Observation And Mechanism Of Prevention Of Anastomotic Fistula By Mussel Mucin After Upper Digestive Tract Surgery

Objective:To observe the effect and mechanism of mussel mucin on the anastomotic site for resection of esophageal or cardia carcinoma.Methods: Observe the postoperative condition through the animal experiment is 12 average female New Zealand rabbits were divided into two groups,experimental group small intestine cut across the whole layer longitudinal suture spraying mussel adhesive proteins at the same time,the control group in New Zealand rabbit full-thickness suture intestinal wall incision don't spray mussels mucin,respectively at 1,3,7 days after the second surgery on small intestinal suture incision,is apart from the edge of incision 5 mm in full thickness small intestinal wall tissue,paraffin embedding,pathological analysis in 12 rabbits only,for example,repeated 3 times test.106 patients diagnosed with esophageal or cardiac cancer in the fourth hospital of hebei medical university from August 2017 to July 2018 were collected and randomly divided into the experimental group and the control group,53 patients in each group.Experimental group: the implementation of normal esophageal or cardia cancer surgery at the same time in the anastomotic spraying mussels mucin.Results: In animal experiments,there was no anastomotic fistula,no dead rabbit and no allergic reaction in the experimental group and the control group.Histopathology of the control group: histological structure was disordered,with a large number of inflammatory cells,cavities and necrotic tissues,and few fibroblasts;Histopathology of the experimental group showed clear histological structure,with a small amount of inflammatory cell infiltration,few empty and necrotic tissues,and a large number of fibroblasts filling the interstitial space.106 cases of esophageal cancer or cardiac cancer were all successful in the surgical process,and no patients died after surgery.The control group: 10 cases had anastomotic fistula after surgery,with a total incidence of 18.8%.The experimental group: 4 cases had anastomotic fistula after surgery,with a total incidence of 7.5%.Control group: postoperative pulmonary infection occurred in 14 patients,with a total incidence of 26.4%;experimental group: postoperative pulmonary infection occurred in 9 patients,with a total incidence of 17.0%,with no statistically significant difference between the two groups(P>0.05).Control group: the average length of stay was 22.72±13.29 days;experimental group: the average length of stay was 16.79± 11.01 days.The difference between the two groups was statistically significant(P<0.05).The average drainage volume of the experimental group was 936.11 ±590.55 ml 3 days after the operation,and that of the control group was 960.66± 576.75 ml 3 days after the operation.The difference between the two groups was not statistically significant(P>0.05).Conclusion: For the upper digestive tract surgery,spraying mussel mucin at the anastomotic site did not increase the incidence of pulmonary complications,and significantly shortened the length of hospital stay.Its treatment method of preventing anastomotic fistula and promoting anastomotic healing was safe,but it did not significantly reduce the incidence of anastomotic fistula,which may be related to the small sample size.