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评估用于胃肠吻合术的新型圆形和线性吻合器装置的前瞻性试验:初步数据。

Prospective trial evaluating new circular and linear stapler devices for gastrointestinal anastomosis: preliminary data.

作者信息

De Nardi P, Panzeri F, Staudacher C

机构信息

Department of Surgery, San Raffaele Scientific Institute, Milan, Italy.

出版信息

Tech Coloproctol. 2008 Mar;12(1):69-72. doi: 10.1007/s10151-008-0401-2. Epub 2008 May 30.

Abstract

Several commercial models of stapler devices are available. This study evaluated the ease of use, effectiveness and safety of new commercial stapling devices for gastrointestinal anastomosis. A total of 11 patients (5 men) requiring surgical therapy for benign or malignant disease of the digestive tract were recruited between July and October 2006. Eleven patients were treated with KYGW circular stapler or KYFB linear stapler (Changzhou Kangdi Medical Stapler). In these patients, 14 staplers were used and 21 stapled sutures (16 linear, 5 circular) were performed. Number of anastomoses successfully completed, postoperative anastomotic fistula or dehiscence, days to take fluid and normal diet, length of hospital stay and anastomotic stenosis were recorded. A 10-point questionnaire enquiring about the instrument and anastomotic features was administered to surgeons immediately after the operation in the study group and in 10 control patients treated with standard CDH circular and SDH linear staples (Ethicon Endo-Surgery). Mean scores on the questionnaire for the experimental and control groups were good (>7.5) and did not significantly differ for handling, closing ease, bleeding, and overall satisfaction. No case of intra-abdominal sepsis, leakage or intestinal obstruction was recorded in the study group. In the 5 patients with colorectal anastomosis, the anastomotic lumen at 15 days was wide open and at 3 months there were no strictures. These new instruments are valuable for performing gastrointestinal anastomosis and are in conformity with clinical requirements; their use is simple and seems to be safe.

摘要

有几种商业型号的吻合器设备可供使用。本研究评估了用于胃肠道吻合术的新型商业吻合器械的易用性、有效性和安全性。2006年7月至10月期间,共招募了11例因消化道良性或恶性疾病需要手术治疗的患者(5名男性)。11例患者接受了KYGW圆形吻合器或KYFB线性吻合器(常州康迪医用吻合器)治疗。在这些患者中,使用了14个吻合器,进行了21次吻合缝合(16次线性,5次圆形)。记录成功完成的吻合口数量、术后吻合口瘘或裂开、开始进食流食和正常饮食的天数、住院时间以及吻合口狭窄情况。在研究组手术结束后,立即向外科医生发放一份关于器械和吻合特征的10分问卷,并向10名接受标准CDH圆形和SDH线性吻合钉(爱惜康内镜外科)治疗的对照患者发放。实验组和对照组问卷的平均得分良好(>7.5),在操作、闭合难易程度、出血和总体满意度方面无显著差异。研究组未记录到腹腔内感染、渗漏或肠梗阻病例。在5例结直肠吻合患者中,15天时吻合口腔隙通畅,3个月时无狭窄。这些新型器械对于进行胃肠道吻合术很有价值,符合临床要求;其使用简单且似乎安全。

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