Role of magnetic compression power in esophageal anastomosis: an experimental study

Aim
The aim of this study was to asses the role of magnetic power in creation of a complete watertight anastomosis between two created blind esophageal pouches with 3–4-cm distance between them in conditions similar to long-gap esophageal atresia (EA).
Background
Magnetic compression anastomosis (magnamosis) is the practice of using two disc-shaped magnets to form a sutureless anastomosis. It has been proved to be effective in stomach and intestine but has not been tested in esophagus with long-gap EA. To test this notion, a long-gap EA rabbit model was developed.
Materials and methods
A total of 10 New Zealand rabbits of age 8 weeks, weighing between 1.8 and 2 kg, were included. Animals underwent magnetic compression of the esophagus using two disc-shaped magnets after resection of a small segment, creating about 4-cm gap similar to EA. The rabbits survived for 7 days and received nutrition through PEG tube. After 7 days, rabbits were euthanized, and the esophagoesophageal anastomosis was evaluated by radiography, burst pressure test, and histopathology.
Results
Overall, two rabbits died intraoperatively owing to anesthesia adverse effects. Moreover, four rabbits died postoperatively: one rabbit died on the postoperative day 2 owing to esophageal leakage and mediastinitism and three rabbits developed excess oral secretions and respiratory distress and eventually died on postoperative day 4 owing to saliva aspiration and pneumonia. Only four rabbits survived at the end of the experiment. Of the four survived rabbits, three had a well-formed anastomosis. Burst tests showed no leak when injecting saline up to 30 mmHg.
Conclusion
Magnamosis is technically feasible for esophagoesophageal anastomoses. Esophageal gap more than 3–4-cm long requires elongation procedure first before the use of magnamosis.