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Zhang MM, Sha HC, Qin YF, Lyu Y, Yan XP. Y-Z deformable magnetic ring for the treatment of rectal stricture: A case report and review of literature. World J Gastroenterol 2024; 30:599-606. [PMID: 38463020 PMCID: PMC10921145 DOI: 10.3748/wjg.v30.i6.599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Revised: 12/18/2023] [Accepted: 01/16/2024] [Indexed: 02/05/2024] Open
Abstract
BACKGROUND Treatment of postoperative anastomotic stenosis for colorectal cancer is often challenging, especially for patients who do not respond well to endoscopy. In cases where patients have undergone an enterostomy, the stenosis can be easily resolved through magnetic compression. However, common magnetic compression techniques cannot be performed on those without enterostomy. We designed a novel Y-Z deformable magnetic ring (Y-Z DMR) and successfully applied it to a patient with a stenosis rectal anastomosis and without enterostomy after rectal cancer surgery. CASE SUMMARY We here report the case of a 57-year-old woman who had undergone a laparoscopic radical rectum resection (Dixon) for rectal cancer. However, she started facing difficulty in defecation 6 months after surgery. Her colonoscopy indicated stenosis of the rectal anastomosis. Endoscopic balloon dilation was performed six times on her. However, the stenosis still showed a trend of gradual aggravation. Because the patient did not undergo an enterostomy, the conventional endoscopic magnetic compression technique could not be performed. Hence, we implemented a Y-Z DMR implemented through the anus under single channel. The magnetic ring fell off nine days after the operation and the rectal stenosis was relieved. The patient was followed up for six months and reported good defecation. CONCLUSION The Y-Z DMR deformable magnetic ring is an excellent treatment strategy for patients with rectal stenosis and without enterostomy.
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Affiliation(s)
- Miao-Miao Zhang
- Department of Hepatobiliary Surgery, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an 710061, Shaanxi Province, China
- National Local Joint Engineering Research Center for Precision Surgery & Regenerative Medicine, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an 710061, Shaanxi Province, China
| | - Huan-Chen Sha
- Department of Hepatobiliary Surgery, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an 710061, Shaanxi Province, China
| | - Yuan-Fa Qin
- Department of Hepatobiliary Surgery, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an 710061, Shaanxi Province, China
| | - Yi Lyu
- Department of Hepatobiliary Surgery, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an 710061, Shaanxi Province, China
- National Local Joint Engineering Research Center for Precision Surgery & Regenerative Medicine, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an 710061, Shaanxi Province, China
| | - Xiao-Peng Yan
- Department of Hepatobiliary Surgery, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an 710061, Shaanxi Province, China
- National Local Joint Engineering Research Center for Precision Surgery & Regenerative Medicine, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an 710061, Shaanxi Province, China
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Zhang M, Lyu X, Zhao G, An Y, Lyu Y, Yan X. Establishment of Yan-Zhang's staging of digestive tract magnetic compression anastomosis in a rat model. Sci Rep 2022; 12:12445. [PMID: 35859162 PMCID: PMC9300605 DOI: 10.1038/s41598-022-16794-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2022] [Accepted: 07/15/2022] [Indexed: 12/16/2022] Open
Abstract
Magnetic compression anastomosis, also known as magnamosis, is a safe and feasible method for digestive tract anastomosis. However, the pathological process involved in magnamosis of the digestive tract has not been investigated. This study aimed to establish the stages of digestive tract magnamosis in a rat model. Eighty-four Sprague–Dawley albino rats (200–250 g) were randomly divided into 14 groups (n = 6 per group). All rats underwent colonic magnamosis. Starting from postoperative day (POD) 1, one group of rats was sacrificed every other day to obtain the specimens. Burst pressure at the anastomotic site of each specimen was examined. Gross and histological examination of the anastomotic site was performed to establish the stages of the digestive tract magnamosis. Colonic magnamosis was successfully performed in all rats and the mean anastomosis time was 5.62 ± 0.91 min. The postoperative survival rate was 100%. The lowest anastomotic burst pressure was 78.33 ± 3.44 mmHg on POD3. The anastomotic burst pressure gradually increased and stabilized on POD21. Macroscopic and histological examination showed that the anastomotic mucosal and serosal layer did not heal on POD1. The serosal layer of the anastomosis healed by adhesion on POD3, and the mucosal layer began to heal on POD3-11 and was established by POD21. According to the anastomotic bursting pressure, digestive tract magnamosis can be staged into the magnetic maintenance, fragile, strengthening, and stable phases, which on histology correspond to the serosal adhesion formation, serosal healing, mucosal healing, and stereotyping, respectively.
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Affiliation(s)
- Miaomiao Zhang
- Department of Hepatobiliary Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, 277 West Yanta Road, Xi'an, 710061, Shaanxi, China.,National and Local Joint Engineering Research Center of Precision Surgery & Regenerative Medicine, The First Affiliated Hospital of Xi'an Jiaotong University, 277 West Yanta Road, Xi'an, 710061, Shaanxi, China
| | - Xin Lyu
- Department of Pulmonary and Critical Care Medicine, Second Affiliated Hospital, Xi'an Jiaotong University, Xi'an, 710004, Shaanxi, China
| | - Guangbin Zhao
- State Key Laboratory for Manufacturing System Engineering, School of Mechanical Engineering, Xi'an Jiaotong University, Xi'an, 710054, Shaanxi, China
| | - Yingfeng An
- Department of Hepatobiliary Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, 277 West Yanta Road, Xi'an, 710061, Shaanxi, China.,National and Local Joint Engineering Research Center of Precision Surgery & Regenerative Medicine, The First Affiliated Hospital of Xi'an Jiaotong University, 277 West Yanta Road, Xi'an, 710061, Shaanxi, China.,Drug Non-Clinical Evaluation Center of Guangzhou Institute of Pharmaceutical Industry, Guangzhou General Pharmaceutical Research Institute Co. Ltd., Guangzhou, Guangdong, China
| | - Yi Lyu
- Department of Hepatobiliary Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, 277 West Yanta Road, Xi'an, 710061, Shaanxi, China. .,National and Local Joint Engineering Research Center of Precision Surgery & Regenerative Medicine, The First Affiliated Hospital of Xi'an Jiaotong University, 277 West Yanta Road, Xi'an, 710061, Shaanxi, China.
| | - Xiaopeng Yan
- Department of Hepatobiliary Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, 277 West Yanta Road, Xi'an, 710061, Shaanxi, China. .,National and Local Joint Engineering Research Center of Precision Surgery & Regenerative Medicine, The First Affiliated Hospital of Xi'an Jiaotong University, 277 West Yanta Road, Xi'an, 710061, Shaanxi, China.
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