Kawasaki Kentaro, Fujino Yasuhiro, Kanemitsu Kiyonori, Goto Tadahiro, Kamigaki Takashi, Kuroda Daisuke, Kuroda Yoshikazu
Division of Gastroenterological Surgery, Department of Clinical Molecular Medicine, Kobe University Graduate School of Medicine, 7-5-2, Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan.
Surg Endosc. 2007 Oct;21(10):1796-9. doi: 10.1007/s00464-007-9265-1. Epub 2007 Mar 13.
The single stapling technique (SST) and the double stapling technique (DST) are common anastomoses for rectal cancer. Although many mechanical devices have been developed, the best choice remains unclear. In this study we examined the strength of anastomoses by determining their bursting pressures using an animal model.
The intestines of pigs were used. In experiment 1, we compared the bursting pressures for Endo GIA 60 blue, Endo GIA 60 green, and GIA 60 blue. In experiment 2, the bursting pressures of a buttressed cutting site and a nonbuttressed cutting site were measured. In experiment 3, the SST, DST, and DST with buttress using PCEEA were performed and the bursting pressures and points of these anastomoses were examined.
The bursting pressure of Endo GIA 60 blue (80.3 +/- 10.5 mmHg) was significantly higher than that of Endo GIA 60 green (37.3 +/- 4.2 mmHg) and GIA 60 blue (31.7 +/- 5.8 mmHg) (p < 0.01). When a cut end was buttressed, the bursting pressure (149.6 +/- 37.6 mmHg) was significantly higher than that of the nonbuttressed end (75.3 +/- 25.1 mmHg) (p < 0.01). The bursting pressure among SST, DST, and DST with buttress was not significantly different. Only one bursting point was the crossing point of the PCEEA and Endo GIA and the bursting pressure of this point was much lower than that of the others.
Endo GIA was most suitable for DST. The SST, DST, and DST with buttress had almost the same strength. The crossing point of PCEEA and Endo GIA may be a dangerous point for DST.
单吻合器技术（SST）和双吻合器技术（DST）是直肠癌常见的吻合方式。尽管已经研发出许多机械装置，但最佳选择仍不明确。在本研究中，我们通过使用动物模型测定吻合口的破裂压力来检验吻合口的强度。
使用猪的肠道。在实验1中，我们比较了Endo GIA 60蓝色、Endo GIA 60绿色和GIA 60蓝色的破裂压力。在实验2中，测量了有支撑切割部位和无支撑切割部位的破裂压力。在实验3中，进行了SST、DST以及使用PCEEA带支撑的DST，并检查了这些吻合口的破裂压力和破裂点。
Endo GIA 60蓝色的破裂压力（80.3±10.5 mmHg）显著高于Endo GIA 60绿色（37.3±4.2 mmHg）和GIA 60蓝色（31.7±5.8 mmHg）（p<0.01）。当切割端有支撑时，破裂压力（149.6±37.6 mmHg）显著高于无支撑端（75.3±25.1 mmHg）（p<0.01）。SST、DST以及带支撑的DST之间的破裂压力无显著差异。只有一个破裂点是PCEEA和Endo GIA的交叉点，该点的破裂压力远低于其他点。
Endo GIA最适合用于DST。SST、DST以及带支撑的DST强度几乎相同。PCEEA和Endo GIA的交叉点可能是DST的危险点。
