Balaji N S, Macklin C P, Fawole S, Aster A S, Rao V S R, Moore P J, Ahmad S M
Colorectal Surgical Unit, Scunthorpe General Hospital, Scunthorpe, UK.
Surgeon. 2007 Aug;5(4):199-201. doi: 10.1016/s1479-666x(07)80002-3.
Stapled techniques of coloanal anastomosis in anterior resection have gained widespread acceptance over hand anastomosis. We believe a modification of the 'triple staple technique' has ergonomic advantages over existing stapling methods and present our technique and experience here.
Fifty consecutive patients underwent anterior resection with a concomitant defunctioning ileostomy in 44 (86%) patients. A modified triple staple technique of side to end coloanal anastomosis was performed without the need of a purse string suture on the proximal and the distal segments.
There were no major intra-operative complications. 2/50 (4%) clinical leaks and 2/37 (5.4%) radiological leaks were noted. A combined leak rate of 4/50 (8%) was reported. The incidence of anastomotic stricture encountered was 1/50 (2%).
The modified triple staple technique for side to end anastomosis in anterior resection has ergonomic advantages and comparable safety to the existing techniques of stapling coloanal anastomosis. We believe this technique can be widely adopted as an added alternative to the current techniques of stapled anastomosis after anterior resection.
在低位前切除术（直肠前切除术）中，吻合器行结肠肛管吻合技术已比手工吻合更广泛地被接受。我们认为改良的“三重吻合器技术”比现有的吻合方法具有人体工程学优势，并在此介绍我们的技术和经验。
连续50例患者接受低位前切除术，其中44例（86%）同时行暂时性回肠造口术。采用改良的端侧结肠肛管吻合三重吻合器技术，近端和远端无需荷包缝合。
术中无严重并发症。发现2/50（4%）有临床吻合口漏，2/37（5.4%）有影像学吻合口漏。报道的吻合口漏综合发生率为4/50（8%）。吻合口狭窄发生率为1/50（2%）。
改良的低位前切除术中端侧吻合三重吻合器技术具有人体工程学优势，与现有的结肠肛管吻合器技术安全性相当。我们认为该技术可作为低位前切除术后吻合器吻合现有技术的一种补充选择被广泛采用。
