Rodolico G, Cavallaro V, Minutolo V, Fragati G, Bonaccorso R, Craxi G, Barbarino F
Università di Catania, Istituto di I Clinica Chirurgica Generale e Terapia Chirurgica.
Minerva Chir. 1990 Apr 30;45(8):545-53.
After a review of the technical development and application of staplers from their introduction to the present day, the indications to the use of this instrument in all gastroenterological areas from the oesophagus to the rectum as well as in chest, gynaecological and urological surgery specified. The advantages offered by staplers in the creation of intestinal anastomoses are undeniable, but these instruments must be considered alternatives to traditional surgery, the techniques of which should be well known to all surgeons. In certain areas (gastric, ileal and colonic resections etc.), the now widespread return to single thread manual stitches sheds a new light on staplers and reflects the fact that an anastomosis can be performed just as quickly by hand but will be softer and less rigid than a stapled one. It is only in oesophageal and lower rectal surgery that staplers offer a significant advantage, solving problems where hand suturing cannot.
在回顾吻合器从问世至今的技术发展及应用情况后,明确了该器械在从食管到直肠的所有胃肠病学领域以及胸科、妇科和泌尿外科手术中的使用指征。吻合器在肠道吻合术中所具有的优势是不可否认的,但这些器械应被视为传统手术的替代方法,所有外科医生都应熟知传统手术技术。在某些领域(如胃、回肠和结肠切除术等),如今广泛回归到单丝线手工缝合,这为吻合器带来了新的认识,并反映出这样一个事实,即手工进行吻合术同样可以很快完成,而且比吻合器吻合更柔软、更不易僵硬。只有在食管和直肠下段手术中,吻合器才具有显著优势,能够解决手工缝合无法解决的问题。