Email this article Experimental Simulation of Compression Anastomosis in Double-Barreled Enterostomy Using a Titanium Nickelide Memory Shape Device
- Authors: Ivanov S.D.1, Slizovskiу G.V.1, Shikunova Y.V.1, Vtorushin S.V.1, Vasilchenko D.V.1, Gunther V.E.2, Khodorenko V.N.2, Anikeev S.G.2
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Affiliations:
- Siberian State Medical University
- Research Institute of Medical Materials and Implants with Shape Memory of Siberian physical-technical institute TSU
- Issue: Vol 15, No 1 (2022)
- Pages: 46-57
- Section: Original articles
- URL: https://ogarev-online.ru/2070-478X/article/view/149030
- DOI: https://doi.org/10.18499/2070-478X-2022-15-1-46-57
- ID: 149030
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Abstract
Introduction. Enterostomy remains a relevant option of staged treatment of small intestine diseases in children. T-anastomosis with stoma (Bishop-Koop) and double-barreled enterostomy with compression anastomosis (Mikulicz) are among the most widely accepted ones. Disadvantages of compression anastomosis can be eliminated by using a NiTi-clip with shape memory.
The aim of the study was to perform an experimental study to detect effectiveness and advantages of NiTi-clip application in formation of a compression anastomosis in a double-barreled enterostomy compared with manual T-anastomosis.
Methods. The study included 24 rabbits of the "Serebristyi" breed, aged 2.5-3 months, weighed 2790-3100 g; they were divided into two equal groups. Autopsy was performed in 10, 14, 21 days with pneumopression and histological examination. Differences were considered statistically significant at p-value <0.05.
Results. The duration of the Mikulicz operation (group A) was significantly shorter than that of Bishop-Koop`s (group B) (p = 0.000). Significant differences in weight were found in 14. 21 days, with a predominance in group A (p = 0.029). Complications included wound suppuration, eventration, peritonitis, evagination, dermatitis, and anastomotic leakage. In 10 days, compression anastomosis had a lower anastamotic pressure, but in 21 days, it was more stabile than in manual anastomosis (p = 0.019). In 14 days, inflammatory changes in the mucosa with fibrosis in the muscle layers and lesions were detected in the area of manual anastomosis, they were accompanied by inflammation around sutures. In 21 days, fibrotic changes spread in all layers. Proliferation prevailed over inflammation in the area of the compression anastomosis.
Conclusions. Double-barreled stoma formation with NiTi-clip application took less time than T-anastomosis. Animals with a double-barreled stoma and compression anastomosis had a larger weight gain. Compression anastomosis with NiTi-clip in the stoma was stabile than manual anastomosis. With compression anastomosis, layer-by-layer regeneration from serous to mucous membrane occurs, healing occurred faster, with a predominance of proliferation processes, the risk of stenosis decreased. The use of NiTi-clip in the surgical treatment of children with double-barreled enterostomy can be recommended for practical use.
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##article.viewOnOriginalSite##About the authors
Stanislav Dmitrievich Ivanov
Siberian State Medical University
Email: ivanov_st@mail.ru
ORCID iD: 0000-0001-8439-901X
SPIN-code: 2839-2810
Scopus Author ID: 57207574392
ResearcherId: ABD-7468-2020
pediatric surgeon, postgraduate student at the pediatric surgery department
Russian Federation, 2 Moskovsky trakt str., Tomsk, 634050, RussiaGrigoriу Vladimirovich Slizovskiу
Siberian State Medical University
Email: sgv5858@mail.ru
ORCID iD: 0000-0001-8217-5805
SPIN-code: 1653-0653
M.D., professor, head of pediatric surgery department
Russian Federation, 2 Moskovsky trakt str., Tomsk, 634050, RussiaYana Vladimirovna Shikunova
Siberian State Medical University
Email: yana-z@mail.ru
ORCID iD: 0000-0002-7288-6678
SPIN-code: 4456-5278
Ph.D., assistant professor at the pediatric surgery department
Russian Federation, 2 Moskovsky trakt str., Tomsk, 634050, RussiaSergey Vladimirovich Vtorushin
Siberian State Medical University
Email: wtorushin@rambler.ru
ORCID iD: 0000-0002-1195-4008
SPIN-code: 2442-4720
M.D., professor at the pathology department
Russian Federation, 2 Moskovsky trakt str., Tomsk, 634050, RussiaDmitrii Vladimirovich Vasilchenko
Siberian State Medical University
Email: vasilchenkodmitry1991@gmail.com
ORCID iD: 0000-0002-9780-0770
SPIN-code: 8250-2606
M.D., assistant professor at the pathology department
Russian Federation, 2 Moskovsky trakt str., Tomsk, 634050, RussiaViktor Eduardovich Gunther
Research Institute of Medical Materials and Implants with Shape Memory of Siberian physical-technical institute TSU
Email: hodor_val@mail.ru
ORCID iD: 0000-0002-6803-5934
SPIN-code: 9015-1666
Ph.D., professor, director of institute
Russian Federation, 17, 19- Gvardeiskoi Divizii str., Tomsk, 634045, RussiaValentina Nikolaevna Khodorenko
Research Institute of Medical Materials and Implants with Shape Memory of Siberian physical-technical institute TSU
Email: hodor_val@mail.ru
ORCID iD: 0000-0002-5705-4072
SPIN-code: 3284-6574
Cand. Sci. (Phys.-Math.), senior researcher
Russian Federation, 17, 19- Gvardeiskoi Divizii str., Tomsk, 634045, RussiaSergei Gennadievich Anikeev
Research Institute of Medical Materials and Implants with Shape Memory of Siberian physical-technical institute TSU
Author for correspondence.
Email: anikeev_sergey@mail.ru
ORCID iD: 0000-0001-9323-5973
SPIN-code: 8054-6426
Cand. Sci. (Phys.-Math.), senior researcher
Russian Federation, 17, 19- Gvardeiskoi Divizii str., Tomsk, 634045, RussiaReferences
- Eeftinck Schattenkerk L.D., Backes M., W.J. de Jonge et al., Treatment of Jejunoileal Atresia by primary anastomosis or Enterostomy: Double the operations, double the risk of complications, Journal of Pediatric Surgery. 2021; 12:57 doi: 10.1016/j.jpedsurg.2021.07.021
- Haricharan R. N., Gallimore J. P., Nasr A. Primary anastomosis or ostomy in necrotizing enterocolitis?. Pediatric surgery international. 2017; 33(11): 1139–1145. doi: 10.1007/s00383-017-4126-z.
- Wit J., Sellin S., Degenhard P., Scholz M., Mau H. Is the Bishop-Koop anastomosis in treatment of neonatal ileus still current. Chirurg. 2000; 71: 307—310.
- Peng Y. F., Zheng H. Q., Zhang H., He Q. M., Wang Z., Zhong W., et al. Comparison of outcomes following three surgical techniques for patients with severe jejunoileal atresia. Gastroenterology report. 2019; 7(6): 444–448. doi: 10.1093/gastro/goz026
- Haithem H Ali Almoamin. Meconium ileus a study and comparison between common operative procedures performed in basrah. Basrah Journal of Surgery. 2016; 22(2): 84–90. doi: 10.33762/bsurg.2016.116618.
- Bell R.H., Johnson F.E., Lilly J.R. Intestinal anastomoses in neonatal surgery. Annals of surgery. 1976; 183(3): 276–281. doi: 10.1097/00000658-197603000-00011.
- Popov F.B., Nemilova T.K., Karavaeva S.A. Enterostomy in emergency abdominal surgery of newborns. Detskaya khirurgiya. 2004; 5: 20–23. (in Russ).
- Gatkin E.Ya., Razumovskiy A.Yu., Korsunkiy A.A.., Konovalov A.K., Sergeev A.V., Vinogradov A.Ya. i dr. Interintestinal anastomoses formation using permanent magnet in surgical treatment of children with intestinal stomas. Khirurgiya. 2015; 5: 45–50. doi: 10.17116/hirurgia2015545-50. (in Russ.)
- Bisaliev B.N. Tsap N.A., Tusupkaliev A.B., Dosmagambetov S.P., Zhalmukhanbetov K.K., Grzhibovskii A.M. The use of magnetic compression interintestinal anastomosis in the treatment of children with enterostomies. Novosti khirurgii. 2020; 28(1): 46–52. doi: 10.18484/2305-0047.2020.1.46. (in Russ)
- Zigan'shin R.V., Gyunter V.E., Gibert B.K. Compression anastomoses in gastrointestinal surgery performed with a shape memory alloy device. Khirurgiya. 1990; 8: 115–120. (in Russ)
- Gyunter V.E., Dambaev G.Ts., Sysolyatin P.G., Zigan'shin R.V., i dr. Medical materials and implants with shape memory. Tomsk: Izd-vo Tom. un-ta, 1998. 487с. (in Russ)
- Aksel'rov M.A The first experience of using delayed compression anastomosis with bowel resection in peritonitis in children. Detskaya khirurgiya. 2010; 4: 51–52. (in Russ).
- Balaganskii D.A., Karavaev A.V., Osipkin V.G., Vedernikov V.A., Slizovskii G.V., Gyunter V.E. The use of titanium nickelide compression devices with shape memory in the treatment of intestinal obstruction in childhood. Meditsina v Kuzbasse. 2007; 1: 12–13. (in Russ).
- Nikitchenko V.E., Naumova E.I., Shuber S.S.M. Morphological structure of the gastrointestinal tract of rabbits. Vestnik Rossijskogo universiteta druzhby narodov. Serija: Agronomija i zhivotnovodstvo. 2015; 1. 18–24. URL: https://cyberleninka.ru/article/n/morfologicheskoe-stroenie-zheludochno-kishechnogo-trakta-krolikov (in Russ).
- Dindo D, Demartines N, Clavien P.A. Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg. 2004; 240(2): 205–213. doi: 10.1097/01.sla.0000133083.54934.ae
- Egorov V.I., Mechanical methods for assessing the healing of gastrointestinal joints. Annaly khirurgii. 2001; 3. 25–28.
- Turusov R.A., Egorov V.I., Schastlivtsev I.V., Baranov A.O., Prut E.V.. Mechanical and biological aspects of the problem of human intestinal anastomosis. Mekhanika kompozitsionnykh materialov i konstruktsii. 1999; 5(4): 109–135. URL: https://mkmk.ras.ru/1999/механические-и-биологические-аспект/
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