Novosti
Khirurgii

V.A. SHOTT

EXPERIMENTAL EVALUATION OF GASTROINTESTINAL-JEJUNUM ANASTOMOSIS SUTURES

Objectives. To determine better variants of sutures in formation anastomosis between the stomach and jejunum during Billroth-2 resection of the stomach.
Methods. During the experiments on dogs (39 animals), Billroth-2 resection of the stomach with the formation of anastomosis of the stomach stump in the side of the jejunum using different types of sutures – Albert’s suture, Schieden’s suture, U-shaped serous-muscular-submucosal, mechanical, everted and inverted sutures was performed. Complications, the number and causes of lethal outcomes were analyzed. Macroscopic evaluation of changes in the anastomosis, regeneration dynamics of the mucous coat in the anastomosis sutures region as well as the character of the adhesive process in the intervention zones was carried out. Permeability and strength of sutures were studied. Quantitative morphometrics was done and the content of microbes was determined.
Results. Formation of anasthomosis between the stomach and jejunum using a mechanical suture gives better results. Essential difference between the inverted mechanical and everted mechanical sutures was revealed. It was found out that the closure of the cranial and caudal angles of anastomosis is more preferably to be performed using U-shaped serous-muscular-submucosal suture. It doesn’t require the second line of sutures as well as possesses haemostatic effect and adapts well the stomach and jejunum tissues.
Conclusions. It is reasonable to form anastomosis of the stomach stump with the jejunum at the Billroth-2 resection of the stomach using the worked out technique with a mechanical suture application.

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