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. 2021 Oct;51(10):1713-1719.
doi: 10.1007/s00595-021-02267-9. Epub 2021 Mar 20.

Intestinal mucosa staple line integrity and anastomotic leak pressure after healing in a porcine model

Daishi Naoi  1 , Hisanaga Horie  2 , Koji Koinuma  2 , Yuko Kumagai  2 , Gaku Ota  2 , Mineyuki Tojo  2 , Yuji Kaneda  2 , Shuji Hishikawa  2 , Ai Sadatomo  2 , Yoshiyuki Inoue  2 , Noriyoshi Fukushima  3 , Alan Kawarai Lefor  2 , Naohiro Sata  2
Affiliations

Intestinal mucosa staple line integrity and anastomotic leak pressure after healing in a porcine model

Daishi Naoi et al. Surg Today. 2021 Oct.

Abstract

Purpose: The aim of this study was to evaluate both the intestinal mucosa staple line integrity and anastomotic leak pressure after healing in a porcine survival model.

Methods: We used two suture models using two different size staples (incomplete mucosal closure model: group G [staple height 0.75 mm], complete mucosal closure model: group B [staple height 1.5 mm]) in the porcine ileum. Five staple lines were created in each group made in the ileum for each model, and the staple sites harvested on days 0, 2, and 7. The leak pressure at the staple site was measured at each time point.

Results: On day 0, the leak pressure for group G (79.5 mmHg) was significantly lower than that for group B (182.3 mmHg) (p < 0.01). On days 2 and 7, there was no significant difference between groups G and B (171 mmHg and 175.5 mmHg on day 2, 175.5 mmHg and 175.5 mmHg on day 7, p > 0.05). The histological findings in both groups showed similar healing at postoperative days 2 and 7.

Conclusion: The integrity of the mucosal staple lines was associated with the postoperative leak pressure on day 0. However, there was no association with the leak pressure at two days or more postoperatively in a porcine model.

Keywords: Anastomosis; Leak pressure; Mucosal suture; Porcine model; Stapler.

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