Comparison of anastomotic suturing techniques in the rat esophagus

Background. Long-gap esophageal atresia continues to be a challenging pedia tric thoracic surgical problem. Despite the use of various tension relievin g procedures, the esophageal anastomosis is often performed under considera ble tension. Excessive tension can cause anastomotic sutures to pull throug h the esophageal tissue, with resultant early esophageal anastomotic dehisc ence, To test the hypothesis that interrupted horizontal mattress sutures w ould withstand the forces of tension better than interrupted simple sutures , an experimental study of rat esophageal anastomoses was done. Methods. Twenty rats were killed and their esophagi were excised. The esoph agi were divided in the mid portion and end-to-end anastomoses were done us ing interrupted 6-0 polypropylene sutures. Ten rats had anastomoses done wi th interrupted simple sutures and ten had interrupted horizontal mattress s uturing. Anastomotic breaking strength was tested in a tensiometer, Results,Anastomotic breaking strength was 3.22+/-0.56 N for the interrupted simple sutured anastomoses and 3.51+/-0.61 N for the interrupted horizonta l mattress group (p=0.30), The difference was not significant. Conclusions, In this animal study interrupted simple and horizontal mattres s suturing withstood the disruptive forces of anastomotic tension equally w ell.