Akira Yaita

The use of Chitin as a new absorbable suture material ― An experimental study

A comparative study of four absorbable suture materials, namely; poly-N-acetylglucosamine (Chitin), polyglycolic acid (PGA), plain catgut and chromic catgut, in terms of strength, elongation, tensile strength retention and tissue reaction, was undertaken. The straight pull strength of USP 3–0 size Chitin was over 2.6 kg, compared with PGA, which was over 3.4 kg and the catguts, which were over 2.0 kg. Chitin showed the lowest elongation among the four. The tensile strength retention (TSR) of Chitin in muscle was 45 per cent at 14 days and 7 per cent at 25 days, which was similar to that of PGA. The TSR of Chitin was maintained by 35 per cent in gastric juice, 97 per cent in bile and 100 per cent in pancreatic juice after immersion for 30 days. The corresponding values for PGA were 54 per cent, 0 per cent and 0 per cent, respectively, whereas both catguts had dissolved within 30 days. The tissue reaction of Chitin was similar to that of PGA, whereas the catguts caused more intense tissue reaction.

Lymphangioma of the esophagus presenting symptoms of achalasia —A case report

A case of lymphangioma of the esophagus with symptoms of achalasia was presented. Compressible and folded intramural tumors were found from the middle to the lower part of the esophagus and the Mecholyl test was positive. After incisional biopsy at lower esophagus through full thickness of the wall, the opening was repaired with Thal-Hatafuku’s fundic patch procedures to relieve achalasia. Postoperative course was uneventful and symptoms of achalasia completely disappeared.

Use of free peritoneal patch in reenforcing alimentary tract anastomosis

The use of free peritoneal patch was evaluated for the effect on protection against intestinal anastomotic leakage in dogs. Free peritoneal patch was found to be effective in preventing the anastomotic leakage of the alimentary tract in borderline situation. Free peritoneal patch was more effective when applied with the ‘smooth side out’ than with the “smooth side in’. The usefulness of free peritoneal patch was also demonstrated in the treatment of the already established fistula of the cervical esophagus.

The effect of cartilage-bone marrow extract (CBME) on the healing of intestinal anastomosis

The intestinal anastomosis made under various conditions with and without treatment with cartilage-bone marrow extract were compared. The preoperative or postoperative administration of cartilage-bone marrow extract was found to increase mechanical strength of the intestinal anastomosis, even under unfavorable conditions such as hypoproteinemia, long term treatment of corticoid or reanastomosis. Formation of connective tissue and healing process were also found to be promoted by cartilage-bone marrow extract treatment.

A laterally rotating surgical device attached to the operating table

A laterally rotating surgical device that can be attached to conventional operating tables is described. The position of the patient can be safely and rapidly changed from a supine to a right or left lateral position of 60°. This device is beneficial for performing operations using a thoracoabdominal approach such as is used in cases of resection of gastroesophageal cancer.

An experimental study on an absorbable suture material, chitin.

新しい吸収性縫合糸chitinをPGA, plain catgut, chromic catgutと, 強度と弾性, 消化液中の抗張力推移, およびイヌ小腸吻合時の組織反応の点で比較して次の結果を得た.1.全縫合糸ともUSP 3-0で2.0kg以上と十分な抗張力であったが, chitinの伸び率は他の縫合糸よりわずかに低かった.2.chitinは人工胃液中では30日目で抗張力が35%に減弱したが, 胆汁中では97%, 膵液中では100%と変化はなかった.PGAはそれぞれ54%, 0%, 0%であり, 両catgutは30日目までに溶解した.3.縫合糸周囲の組織反応は, 両catgutが強くchitinはPGAと同程度であった.以上, chitinはPGAにそん色のない縫合糸といえる.

An Alternative One Layer Inverting Suture Technique for Intestinal Anastomosis

An alternative method of anastomosis using a suture one layer inverting was proposed, in which the sutures are placed the serosa, proper muscle layer, submucosal layer and muscularis mucosae, but not mucosa.An experimental study using canine intestine revealed that tensile strength as well as bursting pressure at the anastomotic site is significantly superior in our method to the end-on method.