Abstract
This study was performed to compare three methods of esophageal anastomosis. Twenty four healthy adult dogs were used in this study. The animals were divided into three groups; each one consisted of 8 animals. In group 1; two layers were used to perform the esophageal anastomosis. The first layer represented simple interrupted suture to close the mucosa with knot inside the lumen, and the second layer represented horizontal mattress interrupted suture to close the other layers of esophagus. While in group 2; one layer of cross interrupted mattress suture was used to close all layers of esophageal wall, and in group 3; one layer of Schmieden's suture was used to close all layers of esophageal wall. The results of clinical, radiological and histopathological studies after 15 and 30 days of surgical operation revealed that most of the animals showed different degrees of difficulty concerning the moderate dysphagia and regurgitation. The radiological study showed significant difference of stenosis. The best results were recorded in the second group where the mean degree of stenosis was 7.69%, however the mean degree of stenosis was 42.80% in the first group, while the mean degree of stenosis in the third groups was 37.81%, through 30 days. The histopathological study of group 2 showed rapid healing of the site of anastomosis, lack of granulation tissue and consequently the less degree of stricture and other complications as compared with groups 1 and 3. The Schmieden's suture was characterized by its standard short time as compared with group 1 and 2, although accompanied by some complications. In conclusion this study revealed that the cross mattress suture used in the second group characterized by faster healing and minimal amount of fibrous tissue formation manifested by decrease in moderate degree of stenosis as compared with the two other suture patterns used in the first and third groups.
Highlights
Different suture techniques were used in anastomosis of esophagus in one or two layers
In this study we introduce two new techniques, cross interrupted mattress suture and Schmieden's suture by one layer and compared with other routine method of simple interrupted of mucosa and horizontal mattress suture of other layers of esophageal wall that means by two layers
Radiography The degree of stenosis in the esophagus was considered as slight in the second group (7.69%) as in (Fig.1), after 30 days of operation and moderate in the first and third groups, (42.80%) as in (Fig.2) and (37.81%) as in (Fig.3), respectively during 30 days after operation
Summary
Different suture techniques were used in anastomosis of esophagus in one or two layers. Simple interrupted suture by two layers and one layer were used to anastomose the esophagus in dogs and showed that one layer had better healing than two layers [1]. While [4] showed that there were some complications associated with one layer of esophageal anastomosis such as leakage and stenosis. The esophageal anastomosis by using interrupted suture in two layers had observed better results as compared with other methods [6,7,8]. On the other hand others find that one layer suture technique was better than two layers suture technique for esophageal anastomosis in pigs, dogs and cats [9,10]. In this study we introduce two new techniques, cross interrupted mattress suture and Schmieden's suture by one layer and compared with other routine method of simple interrupted of mucosa and horizontal mattress suture of other layers of esophageal wall that means by two layers
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