Esophageal Suture Anastomosis: An Experimental Study in Piglets

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Abstract
End-to-end suture anastomosis of the entire wall, the mucosal layer and the muscular layers of the esophagus and selective interruption of its mucosa and muscular layers were performed in a series of piglets. Healing in suture anastomosis of the entire esophageal wall and the mucosa layer alone occurred with varying degrees of tissue fibrosis, which uniformly caused reduction of elasticity at the anastomotic site. The least extensive fibrosis was encountered in anastomoses involving only the muscular layers. In these instances no reduction of anastomotic width or elasticity could be demonstrated. Mucosal interruption alone resulted in extensive fibrosis with subsequent complete obliteration of the esophageal lumen. Conversely, interruption of the muscular layers resulted in negligible fibrosis and caused neither organic nor functional obstruction. The results of this study indicate a relationship between defective mucosal contact or mucosal damage and stricture formation.

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