Dresing K, Stock W
Chirurgische Abteilung, Marien-Hospital, Düsseldorf, Federal Republic of Germany.
Surg Endosc. 1991;5(2):83-8. doi: 10.1007/BF00316843.
Following preliminary studies on 15 pig-bowel EEA anastomoses, anastomoses in 20 patients were consecutively examined between the 12th and 14th days after anterior rectum or sigmoid resection. Resections were performed on 16 patients for a malignant tumour and on 4 individuals for a benign lesion. The examination programme included detailed clinical examination of the patient, digital palpation, rectoscopy and endorectal sonography, as well as radiographic examination of the large bowel using aqueous contrast medium 1 day later. All rectoscopic and X-ray findings of anastomotic insufficiency were confirmed by means of endosonography. The sensitivity of the latter technique in verifying the radiographic detection of an insufficiency was 1 and its specificity was 0.82. Endorectal sonographic detection of an anastomotic insufficiency was successful in six cases, and suspected insufficiency was noted on three occasions. Radiographic detection of insufficiency was confirmed in three patients; radiographic results suggested an insufficiency in two cases. On one occasion, a suture insufficiency was confirmed by an immediate operation carried out without a radiographic examination. The present study shows that accurate detection of a suture insufficiency after deep resection is possible with the aid of endorectal sonography.
在对15例猪肠端端吻合术进行初步研究后，对20例患者在直肠前切除或乙状结肠切除术后第12天至第14天连续进行吻合口检查。16例患者因恶性肿瘤行切除术，4例因良性病变行切除术。检查项目包括对患者进行详细的临床检查、指诊、直肠镜检查和直肠内超声检查，以及术后1天使用水性造影剂对大肠进行影像学检查。所有直肠镜和X线检查发现的吻合口功能不全均通过超声内镜检查得以证实。后一种技术在验证影像学检查发现的功能不全方面，敏感性为1，特异性为0.82。直肠内超声检查成功检测出6例吻合口功能不全，3次发现疑似功能不全。3例患者经影像学检查证实存在功能不全；2例影像学结果提示存在功能不全。有1次，在未进行影像学检查的情况下立即进行手术，证实存在缝线功能不全。本研究表明，借助直肠内超声检查能够准确检测深部切除术后的缝线功能不全。
