J.Jpn. Surg. Soc.. 79(2): 111-125, 1978

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Original article

SUTURE METHODS OF ESOPHAGOESOPHAGOSTOMY IN ESOPHAGEAL TRANSECTION FOR BLEEDING VARICES

In 19 dogs the portal vein was constricted with polythene type. Three weeks later, extensive venous collateral channels developed in the gastrohepatic mesentery and paraesophageal veins.
Thoransthoracic esophageal transection was performed in these dogs as the second operation. Transected esophagus was then anastomosed with 5-0 silk. Many interrupted sutures were placed in one hemicircumference of the esophagus whereas only a few sutures were placed in another hemicircumference.
The 14 dogs which survive the two operations were sacrificed at interval of from 3 days to 1 year following the second operation. Process of wound healing stanastomosis was studied by endoscopic observation, by angiograms and by microscopic tissue section.
Direct visualization of the anastomotic site by endoscopy showed no stricture of the suture line with many interrupted sutures, whereas anastomotic stricture was observed in that with a few interrupted sutures.
Considerably more scar tissue was formed in the anastomoses with many sutures than in those with a few sutures by micro angiograms and pathological studies.
Many interrupted sutures of the mucosa is superior to the few interrupted sutures in terms of less stenosis, minimal bleeding from an astomosis and better prevention of the esophageal varices.

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