Abstract
Objective To evaluate the possible biological effect of allogenic mesenchymal stem cells (MSCs) combined with tissue fusion technology on the anastomosis. Methods Sixteen pigs were divided into a 7 d group and 14 d group, each of which was further subdivided into an MSC-treated group and a control group. Five anastomoses per animal were established using LigaSure ForceTriad (Covidien, MA, USA), a tissue sealing system. Cell migration and tissue-specific differentiation potency, in addition to potential cytokine and genetic changes, were investigated. Results There were no significant between-group differences in postoperative complications and anastomosis burst pressure. The number of proliferating cell nuclear antigen- (PCNA-) positive cells was significantly higher in the MSC-treated group as compared with that in the control group (P = 0.021). Labeled MSCs were found in the mucosal layer, villus, and lamina propria, as well as in the lamina muscularis mucosae, where they exhibited characteristics of smooth muscle cells. Conclusions Grafted MSCs significantly promoted epithelial and connective cell proliferation and maintained their cell migration capacity and differentiation potential in the fused anastomotic tissues, without causing severe postoperative complications.
Highlights
The development of innovative surgical instruments has led to major advances in urological, colorectal, gynecological, and general surgery
Since the late 1990s, tissue fusion technology has led to the widespread application of LigaSure, a tissue sealing system, which has been proven to be safer than traditional vessel sealing methods, especially for vessels with diameters of
We evaluated the feasibility and safety of tissue fusion technology in small bowel anastomosis using the LigaSure device in an in vivo porcine model
Summary
The development of innovative surgical instruments has led to major advances in urological, colorectal, gynecological, and general surgery. Surgeons have attempted to use this sealing system in animal models and human clinical procedures for digestive gut sealing or anastomosis [8–15]. These studies have reached no conclusions, irrespective of which type of system or prototype device based on tissue fusion technology was used. We achieved positive results, suggesting that this approach could be used to increase the safety of this type of anastomosis, without the risk of foreign materials Biological techniques, especially those that promote cytokine production, provide a promising alternative to wound healing due to the absence of metal staples, glue, or sutures.
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