Two Anastomotic Widening Procedures for the Repair of Oesophageal Atresia: An Experimental Evaluation

Abstract

Three series of piglets with 10 animals in each were operated on with intrathoracic oesophageal anastomosis. In one series the ends of the oesophagus were brought together with single 6/0 silk sutures (S). In another series with the same suture material each oesophageal end was slit (C). In a third series Z-shaped procedure of the mucosa was performed with 10/0 supramid and the muscular layers were stitched with 6/0 silk sutures (P). The results were assessed with standardized X-ray examination with calculation of anastomotic index, histological examination and macrophoto. Statistically, there was no significant difference in the anastomotic index between the C and P series compared with the control series S. The values were highest in the C series, in which there were four anastomoses that were wider than the best anastomosis in the S series. The histological examination showed in general more pronounced inflammatory and fibrotic reactions in the C and P series as compared with series S. With a great luminal difference between the two organ-ends without the occurrence of a large gap the method seems advantageous. Further widening of the anastomotic circumference with Z-shaped procedure of the mucosa was technically more demanding and did not reduce the stricture formation.