标准 4 排与 6 排 3-D 线性切割吻合器在胃肠道吻合术中的比较：一项前瞻性随机试验。
Comparison of standard 4-row versus 6-row3-D linear cutter stapler in creation of gastrointestinal system anastomoses: a prospective randomized trial.
机构信息
Department of Gastroenterological Surgery, Mersin University Medical Faculty, Mersin, Turkey.
出版信息
Clinics (Sao Paulo). 2012 Sep;67(9):1035-8. doi: 10.6061/clinics/2012(09)09.
OBJECTIVE
This prospective study was conducted to compare the clinical outcomes of a 6-row 3-D linear cutter with the standard 4-row linear cutter in patients who underwent elective gastrointestinal surgery anastomosis.
METHOD
Patients who underwent elective open gastrointestinal surgery that included stapled anastomosis using a linear cutter (Proximate®, Ethicon Endo-Surgery, Cincinnati, OH) between January 2011 and May 2011 were included in the study. The patients were randomly assigned to two groups according to the linear cutter that was used in the surgery: the standard 4-row cutter (the S group) or the new 6-row cutter (the N group). The groups were compared based on the patient demographic data, the laboratory parameters, the preoperative diagnosis, the surgery performed, the operation time, intra-or postoperative complications, the time to oral tolerance and the length of the hospital stay.
RESULTS
The S group included 11 male and nine female patients with a mean age of 65 ± 12 (35-84) years, while the N group included 13 male and eight female patients with a mean age of 62 ± 11 (46-79) years (p =0.448, p = 0.443, respectively). Anastomotic line bleeding was observed in eight (40%) patients in the S group and in one (4.7%) patient in the N group (p = 0.006). Dehiscence of the anastomosis line was observed in two (10%) patients in the S group and none in the N group (p =0.131). Anastomotic leakage developed in three (15%) patients in the S group and in one (4.7%) patient in the N group (p = 0.269). The mean hospital stay was 12.65 ± 6.1 days in theS group and 9.52 ± 2.9 days in the N group (p = 0.043).
CONCLUSION
The 6-row 3-D linear cutter is a safe and easily applied instrument that can be used to create anastomoses in gastrointestinal surgery. The new stapler provides some usage benefits and is also superior to the standard linear cutter with regard to anastomotic line bleeding.
目的
本前瞻性研究旨在比较 6 排 3D 线性切割器与标准 4 排线性切割器在择期胃肠手术吻合患者中的临床效果。
方法
纳入 2011 年 1 月至 2011 年 5 月期间接受吻合术的择期开放胃肠手术患者。根据手术中使用的线性切割器将患者随机分为两组：标准 4 排切割器（S 组）或新型 6 排切割器（N 组）。比较两组患者的人口统计学数据、实验室参数、术前诊断、手术类型、手术时间、围手术期并发症、口服耐受时间和住院时间。
结果
S 组包括 11 名男性和 9 名女性患者，平均年龄为 65±12（35-84）岁，N 组包括 13 名男性和 8 名女性患者，平均年龄为 62±11（46-79）岁（p=0.448，p=0.443）。S 组中有 8 例（40%）患者出现吻合口出血，N 组中有 1 例（4.7%）患者出现吻合口出血（p=0.006）。S 组有 2 例（10%）患者出现吻合口裂开，N 组无患者出现吻合口裂开（p=0.131）。S 组中有 3 例（15%）患者出现吻合口漏，N 组中有 1 例（4.7%）患者出现吻合口漏（p=0.269）。S 组的平均住院时间为 12.65±6.1 天，N 组为 9.52±2.9 天（p=0.043）。
结论
6 排 3D 线性切割器是一种安全且易于应用的器械，可用于胃肠手术吻合。新型吻合器具有一些使用优势，并且在吻合口出血方面优于标准线性切割器。
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