Division of Colon and Rectal Surgery, Department of Surgery, University of Minnesota, Minneapolis, Minnesota, USA.
J Biomed Mater Res B Appl Biomater. 2010 Jan;92(1):48-54. doi: 10.1002/jbm.b.31488.
Anastomotic leakage is a major complication of colorectal surgery. The purpose of this study was to evaluate and compare stapled ileocolic and colon-colon anastomoses with or without a collagen buttress derived from bovine pericardium in the immediate postoperative period.
Various stapling devices were used to create ileocolic and colon-colon anastomoses in a canine model. Ileocolic anastomoses were created by simulating two different techniques: "open" and "laparoscopic". Colon-colon anastomoses were created by using a double-stapled technique. A total of 27 colon anastomoses (13 left colon-colon, 8 right "laparoscopic", and 6 right "open") were created. Anastomoses buttressed with bovine pericardium (n = 15) were compared to anastomoses without any reinforcement (n = 12). Staple lines were evaluated 4 hours after operation. Evaluation included bursting pressure and bursting location.
No stapler device malfunction occurred. Excision rings were complete in all colon-colon anastomoses. All non-buttressed anastomoses burst at the staple line, whereas with buttressed anastomoses the adjacent intestine burst (p = 0.0001). The intestinal bursting pressure of bowel segments with buttressed staple lines (mean, 362 mmHg) was significantly higher than the bursting pressure of non-buttressed staple lines (mean, 204 mmHg, p < 0.0001).
The use of a collagen matrix buttress derived from bovine pericardium in stapled ileocolic and colon-colon anastomoses was safe. Buttressed anastomoses showed greater bursting strength as compared to non-buttressed anastomoses in the immediate postoperative period in a canine model.
吻合口漏是结直肠手术后的主要并发症。本研究旨在评估和比较在即时手术后使用牛心包衍生的胶原基质加强钉合的回肠结肠和结肠结肠吻合术。
在犬模型中使用各种吻合器制造回肠结肠和结肠结肠吻合术。通过模拟两种不同的技术来创建回肠结肠吻合术：“开放式”和“腹腔镜式”。通过双钉合技术创建结肠结肠吻合术。总共创建了 27 个结肠吻合术（13 个左结肠结肠，8 个右“腹腔镜式”，6 个右“开放式”）。用牛心包（n = 15）加强的吻合术与没有任何加固的吻合术（n = 12）进行比较。吻合钉线在手术后 4 小时进行评估。评估包括爆裂压力和爆裂位置。
没有吻合器设备发生故障。所有结肠结肠吻合术的切除环均完整。所有未加强的吻合术均在吻合钉线处破裂，而用加强吻合术则在相邻肠段破裂（p = 0.0001）。具有加强吻合钉线的肠段的肠爆裂压力（平均值，362 mmHg）明显高于未加强吻合钉线的肠爆裂压力（平均值，204 mmHg，p < 0.0001）。
在钉合的回肠结肠和结肠结肠吻合术中使用牛心包衍生的胶原基质是安全的。在犬模型中，即时手术后，加强吻合术的爆裂强度明显高于未加强吻合术。
