Downey Douglas M, Ali Sophia, Goldblatt Matthew I, Saxe Jonathan M, Dolan James P
Department of Surgery, Wright State University School of Medicine, Dayton, OH, USA.
Surg Technol Int. 2007;16:55-60.
Gastrointestinal resections and anastomoses are commonly performed using stapling devices in a wide range of open and laparoscopic procedures. Whether they are hand-sewn or stapled, anastomoses have an associated leak rate that can impart significant morbidity or mortality to a procedure. In addition, bleeding from staple lines can cause additional complications. Staple line reinforcement is one intervention that has been postulated to reduce both the leak rate and associated bleeding risk. This can be accomplished with either material applied exogenously to the staple line, as in an engineered absorbable biomaterial, or it may use a material - either absorbable or nonabsorbable - that is incorporated into the staple line. A number of reinforcements are currently available but all add time and cost to the procedures in which they are used. However, preventing the complications associated with leak and hemorrhage from staple lines may justify the added cost of these devices. A review of the available published literature was performed to review the current data pertaining to the reinforcement of living tissue and anastomoses with these various reinforcements available to surgeons.
在广泛的开放手术和腹腔镜手术中，胃肠道切除和吻合术通常使用吻合器进行。无论是手工缝合还是吻合器吻合，吻合口都有一定的漏出率，这可能会给手术带来严重的发病率或死亡率。此外，吻合钉线出血会导致额外的并发症。吻合钉线加固是一种被认为可以降低漏出率和相关出血风险的干预措施。这可以通过在吻合钉线上外源性应用材料来实现，如工程可吸收生物材料，也可以使用一种可吸收或不可吸收的材料，将其融入吻合钉线中。目前有多种加固材料可供使用，但所有这些材料都会增加使用它们的手术时间和成本。然而，预防与吻合钉线漏出和出血相关的并发症可能证明这些器械增加的成本是合理的。我们对已发表的文献进行了综述，以回顾有关外科医生可用的这些不同加固材料对活体组织和吻合口进行加固的现有数据。
