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<p>Anastomotic leakage most frequently occurs within the first postoperative week, when intrinsic tissue strength is limited. Although bioabsorbable reinforcement materials are widely used, the optimal degradation profile remains unclear. This study evaluated whether short-term bioabsorbable reinforcement improves early mechanical stability compared with medium-term reinforcement in a controlled porcine small bowel model. Ten pigs underwent laparotomy, and three standardized jejunal end-to-end anastomoses were created in each animal: control, short-term reinforcement, and medium-term reinforcement. Animals were sacrificed at 1&#xa0;week (<i>n</i> = 5) or 3&#xa0;weeks (<i>n</i> = 5). The primary endpoint was intraluminal bursting pressure, and rupture location was recorded. At 1&#xa0;week, bursting pressures were 87 (72–98) mmHg in controls, 156 (136–182) mmHg in the medium-term group, and &gt; 200&#xa0;mmHg in the short-term group (<i>p</i> &lt; 0.001). Both reinforcement groups exceeded controls, and short-term reinforcement showed the highest strength. All specimens ruptured at the anastomotic line. At 3&#xa0;weeks, all groups exceeded the measurement limit (&gt; 200&#xa0;mmHg); however, rupture location differed significantly, with controls failing at the suture line and reinforced segments rupturing away from the anastomosis (<i>p</i> &lt; 0.01). Histology demonstrated increased subanastomotic connective tissue thickness in reinforced groups, particularly at 1&#xa0;week. Short-term bioabsorbable reinforcement markedly enhanced early mechanical stability and altered late rupture patterns, suggesting restoration of structural competence. Temporal alignment between degradation and early healing may represent a rational strategy to improve anastomotic outcomes.</p>

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Degradation-optimized Bioabsorbable Reinforcement Enhances Early Anastomotic Stability in a Porcine Small Bowel Model

  • 期刊论文

  • 发表日期：

    2026年5月14日

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  • Katsuya Okada,
  • Mitsuo Miyazawa,
  • Masayasu Aikawa,
  • Junpei Takashima,
  • Hirotoshi Kobayashi,
  • Takuya Minagawa,
  • Osamu Itano

摘要

Anastomotic leakage most frequently occurs within the first postoperative week, when intrinsic tissue strength is limited. Although bioabsorbable reinforcement materials are widely used, the optimal degradation profile remains unclear. This study evaluated whether short-term bioabsorbable reinforcement improves early mechanical stability compared with medium-term reinforcement in a controlled porcine small bowel model. Ten pigs underwent laparotomy, and three standardized jejunal end-to-end anastomoses were created in each animal: control, short-term reinforcement, and medium-term reinforcement. Animals were sacrificed at 1 week (n = 5) or 3 weeks (n = 5). The primary endpoint was intraluminal bursting pressure, and rupture location was recorded. At 1 week, bursting pressures were 87 (72–98) mmHg in controls, 156 (136–182) mmHg in the medium-term group, and > 200 mmHg in the short-term group (p < 0.001). Both reinforcement groups exceeded controls, and short-term reinforcement showed the highest strength. All specimens ruptured at the anastomotic line. At 3 weeks, all groups exceeded the measurement limit (> 200 mmHg); however, rupture location differed significantly, with controls failing at the suture line and reinforced segments rupturing away from the anastomosis (p < 0.01). Histology demonstrated increased subanastomotic connective tissue thickness in reinforced groups, particularly at 1 week. Short-term bioabsorbable reinforcement markedly enhanced early mechanical stability and altered late rupture patterns, suggesting restoration of structural competence. Temporal alignment between degradation and early healing may represent a rational strategy to improve anastomotic outcomes.