Eur J Pediatr Surg 2021; 31(02): 177-181
DOI: 10.1055/s-0040-1710025
Original Article

A Continuous Suture Anastomosis Outperforms a Simple Interrupted Suture Anastomosis in Esophageal Elongation

1   Department of Pediatric Surgery, Universitätsmedizin der Johannes-Gutenberg-Universität, Mainz, Germany
,
Evangelos Tagkalos
2   Department of General, Visceral and Transplant Surgery, Universitätsmedizin der Johannes-Gutenberg-Universität, Mainz, Germany
,
Andreas Lindner
1   Department of Pediatric Surgery, Universitätsmedizin der Johannes-Gutenberg-Universität, Mainz, Germany
,
Hauke Lang
2   Department of General, Visceral and Transplant Surgery, Universitätsmedizin der Johannes-Gutenberg-Universität, Mainz, Germany
,
Axel Heimann
3   Institute for Neurosurgical Pathophysiology, Universitätsmedizin der Johannes-Gutenberg-Universität, Mainz, Germany
,
Oliver J. Muensterer
1   Department of Pediatric Surgery, Universitätsmedizin der Johannes-Gutenberg-Universität, Mainz, Germany
› Author Affiliations

Abstract

Introduction Long-gap esophageal atresia represents a distinct entity among the esophageal atresia spectrum. In many patients, achieving a reasonable anastomosis depends on some millimeters of tissue. We aimed to determine what effect the suturing technique would have on esophageal ex vivo elongation as it may determine the strength of a primary anastomosis.

Materials and Methods In an analysis of porcine esophagi from animals for slaughter (100–120 days old with a weight of 100–120 kg), we determined esophageal length gain of simple continuous and simple interrupted suture anastomoses subjected to linear traction until linear breaking strength was reached. Statistical power of 80% was ensured based on an a priori power analysis using five specimens per group in a separate exploratory experiment.

Results The simple continuous suture anastomosis in 15 porcine esophagi ( = 4.47 cm, 95% confidence interval: 4.08–4.74 cm) outperformed the simple interrupted suture anastomosis in another 15 esophagi ( = 3.03 cm, 95% confidence interval: 2.59–3.43 cm) in length gain (Δ = 1.44 cm, 95% confidence interval: 0.87–2.01 cm, p < 0.0001).

Conclusion Simple continuous anastomoses achieved higher length gain compared with simple interrupted suture anastomoses. This effect warrants an experimental assessment in vivo to assess its potential merits for clinical applicability.



Publication History

Received: 30 November 2019

Accepted: 22 March 2020

Publication Date:
18 May 2020 (online)

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