Evidence map›Paper›PMID 38615148›Full record

ArticleLangenbeck's archives of surgery2024

The mesenteric entry site as a potential weak point in gastrointestinal anastomoses - findings from an ex-vivo biomechanical analysis.

Kamacay Cira, Saskia Nicole Janett, Carina Micheler, Stephan Heller, Andreas Obermeier, Helmut Friess, Rainer Burgkart, Philipp-Alexander Neumann

Open access · hybridAbstract read
In one paragraph

Article in Langenbeck's archives of surgery, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.6field-weighted citation impact, top 31% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 2 citations in OpenAlex.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 1 institution in 1 country.

Kamacay CiraDepartment of Surgery, Klinikum Rechts Der Isar, TUM School of Medicine and Health, Technical University of Munich, 81675, Munich, Bavaria, Germany.ORCID http://orcid.org/0000-0002-2026-2978
Saskia Nicole JanettDepartment of Surgery, Klinikum Rechts Der Isar, TUM School of Medicine and Health, Technical University of Munich, 81675, Munich, Bavaria, Germany.
Carina MichelerDepartment of Orthopaedics and Sports Orthopaedics, Klinikum Rechts Der Isar, TUM School of Medicine and Health, Technical University of Munich, Munich, Germany.
Stephan HellerDepartment of Orthopaedics and Sports Orthopaedics, Klinikum Rechts Der Isar, TUM School of Medicine and Health, Technical University of Munich, Munich, Germany.
Andreas ObermeierDepartment of Orthopaedics and Sports Orthopaedics, Klinikum Rechts Der Isar, TUM School of Medicine and Health, Technical University of Munich, Munich, Germany.
Helmut FriessDepartment of Surgery, Klinikum Rechts Der Isar, TUM School of Medicine and Health, Technical University of Munich, 81675, Munich, Bavaria, Germany.
Rainer BurgkartDepartment of Orthopaedics and Sports Orthopaedics, Klinikum Rechts Der Isar, TUM School of Medicine and Health, Technical University of Munich, Munich, Germany.
Philipp-Alexander NeumannDepartment of Surgery, Klinikum Rechts Der Isar, TUM School of Medicine and Health, Technical University of Munich, 81675, Munich, Bavaria, Germany. P-A.Neumann@tum.de.ORCID http://orcid.org/0000-0001-8361-3934
TUM Klinikum · DE

Funding

Bayerische Forschungsstiftung AZ-1508-21
6 · The paper itself

Abstract

purposeGastrointestinal disorders frequently necessitate surgery involving intestinal resection and anastomosis formation, potentially leading to severe complications like anastomotic leakage (AL) which is associated with increased morbidity, mortality, and adverse oncologic outcomes. While extensive research has explored the biology of anastomotic healing, there is limited understanding of the biomechanical properties of gastrointestinal anastomoses, which was aimed to be unraveled in this study.

methodsAn ex-vivo model was developed for the biomechanical analysis of 32 handsewn porcine end-to-end anastomoses, using interrupted and continuous suture techniques subjected to different flow models. While multiple cameras captured different angles of the anastomosis, comprehensive data recording of pressure, time, and temperature was performed simultaneously. Special focus was laid on monitoring time, location and pressure of anastomotic leakage (LP) and bursting pressures (BP) depending on suture techniques and flow models.

resultsSignificant differences in LP, BP, and time intervals were observed based on the flow model but not on the suture techniques applied. Interestingly, anastomoses at the insertion site of the mesentery exhibited significantly higher rates of leakage and bursting compared to other sections of the anastomosis.

conclusionThe developed ex-vivo model facilitated comparable, reproducible, and user-independent biomechanical analyses. Assessing biomechanical properties of anastomoses offers an advantage in identifying technical weak points to refine surgical techniques, potentially reducing complications like AL. The results indicate that mesenteric insertion serves as a potential weak spot for AL, warranting further investigations and refinements in surgical techniques to optimize outcomes in this critical area of anastomotic procedures.

Indexed as

Anastomotic LeakMesenteryAnastomosis, SurgicalAnimalsSuture TechniquesSwineWound HealingAnastomosisAnastomotic leakageBiomechanicsBursting pressureMesentery

Identifiers

PMID38615148
PMCPMC11016002
OpenAlexW4394786889

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.