Telescopic Anastomosis Research Articles

Telescopic esophageal anastomosis: operative technique, clinical experiences.

The authors reconstructed the continuity of the alimentary tract by performing telescopic esophagogastrostoma in 208 patients who underwent either esophageal resection or total gastrectomy. The substance of the telescopic technique is to invaginate the distal section of any oral tubular organ to the lumen of an aboral tubular one and to fix it there. In case of telescopic esophageal anastomosis a 10-15 mm long esophageal segment is invaginated into the gastric tube or jejunum. A 3-4 mm wide serosal surface of the wall of the distal anastomosing organ straps the esophagus circularly. Ninety-six transthoracic and 12 transhiatal esophagectomies, 19 partial esophageal resections, four esophageal bypasses, and 77 total or extended total gastrectomies were reconstructed using telescopic anastomosis. Undisturbed healing could be observed in 67 patients after esophageal operations and in 46 patients of total gastrectomies. Anastomosis leakage occurred in 12 of 108 patients (11.1%) after cervical esophagogastrostomy. Leakage could be observed in 7 of 44 patients (15.9%) after end to side and in 5 of 64 patients (7.8%) in case of end to end esophago gastrostoma. There were no failures after two cases of cervical esophago-ileocolostoma and 21 of esophagogastrostomas in the thoracic position. All of the 59 intra-abdominal anastomoses healed without complication. Thirteen of 131 patients (9.9%) died after esophageal operations and four of 77 (5.2%) after gastrectomies. There were no mortal complications due to anastomotic leakage. The telescopic anastomosis is a safe alternative method in cases of total gastrectomy or esophageal operation.

Experimental examination of the healing process of telescopic esophageal anastomosis.

The basis of telescopic anastomosis is old, only the practical details of it have changed and improved. The telescopic anastomosis technique is successfully applied in our practice for reconstruction of gastrectomy and esophageal resection. The reason for this study was that data about the healing process of telescopic anastomosis had not been found in the literature. We used four groups of mongrel dogs for our experiments: Group A (n = 3) received 20 mm-long invaginations with a survival time of 7 days; Group B (n = 3) received 10 mm-long invaginations with a survival time of 21 days; Group C (n = 3) received 20 mm-long invaginations with a survival time of 21 days; Group D (n = 3) received 30 mm-long invaginations with a survival time of 21 days. At the end of the above survival times we removed the anastomosing area, measured the bursting pressures and performed morphological and histological examinations. In each case we also performed an anastomosis exactly the same as a completely healed anastomosis and its pressure tolerance was measured (0 day). The pressure tolerance within the anastomosis rises gradually and independently of the length of the invaginated esophageal part. Anastomosis leakage did not occur. The invaginated esophageal part did not suffer any damage. The muscular wall of the intragastric part of the esophagus became covered by the mucosa of the stomach during the healing process and it joined with the esophageal mucosa at the edge of the free end of the esophagus.

Microsurgical anastomosis of vas deferens by a telescopic technique.

A telescopic microsurgical anastomosis of the vas deferens was performed on 24 rats. Sequential histological examination demonstrated mucosal healing in 7 days. Healing was complete in 21 days, and tubal patency was confirmed by histology in 100% of the cases.

Telescopic anastomosis of the common bile duct in the rat.

A telescopic technique for the end-to-end anastomosis of the common bile duct in the rat is proposed as a way of reducing the number of sutures without prejudicing the impermeability of the union. Serial histological examinations of the scar process after 10, 20, and 30 days showed that patency was maintained.

Late results of telescopic internal mammary-coronary artery anastomosis

Seven dogs had telescopic anastomosis of the IMA to the LAD or CCA. Twenty-two to twenty-eight months later all anastomoses were patent, but one was severely stenotic and three were moderately stenotic. Of the six dogs that were studied by right-heart bypass four demonstrated deterioration of LV function with IMA occlusion. Metabolic data were combined from six dogs and revealed changes similar to those observed in normal dogs with occlusion of the LAD, but with a blunted reactive hyperemia response.

Ventricular function, coronary flow, and oxygen consumption after telescopic internal mammary-coronary anastomosis

Ventricular function, coronary flow, and oxygen consumption after telescopic internal mammary-coronary anastomosis

Telescopic Anastomosis of Sigmoid Flexure of Colon into Lateral Opening in Rectum

Telescopic Anastomosis of Sigmoid Flexure of Colon into Lateral Opening in Rectum