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胃癌患者的无缝合空肠-空肠吻合术:单机构中与手工缝合手术的比较。

Sutureless jejuno-jejunal anastomosis in gastric cancer patients: a comparison with handsewn procedure in a single institute.

作者信息

Marano Luigi, Braccio Bartolomeo, Schettino Michele, Izzo Giuseppe, Cosenza Angelo, Grassia Michele, Porfidia Raffaele, Reda Gianmarco, Petrillo Marianna, Esposito Giuseppe, Di Martino Natale

机构信息

Institution VIII General and Gastrointestinal Surgery, Chief Prof N Di Martino, School of Medicine, Second University of Naples, Piazza Miraglia 2, 80138 Naples, Italy.

出版信息

BMC Surg. 2012;12 Suppl 1(Suppl 1):S27. doi: 10.1186/1471-2482-12-S1-S27. Epub 2012 Nov 15.

Abstract

BACKGROUND

The biofragmentable anastomotic ring has been used to this day for various types of anastomosis in the gastrointestinal tract, but it has not yet achieved widespread acceptance among surgeons. The purpose of this retrospective study is to compare surgical outcomes of sutureless with suture method of Roux-and-Y jejunojejunostomy in patients with gastric cancer.

METHODS

Two groups of patients were obtained based on anastomosis technique (sutureless group versus hand sewn group): perioperative outcomes were recorded for every patient.

RESULTS

The mean time spent to complete a sutureless anastomosis was 11 ± 4 min, whereas the time spent to perform hand sewn anastomosis was 23 ± 7 min. Estimated intraoperative blood loss was 178 ± 32 ml in the sutureless group and 182 ± 23 ml in the suture-method group with no significant differences. No complications were registered related to enteroanastomosis. Intraoperative mortality was none for both groups.

CONCLUSIONS

The Biofragmentable Anastomotic Ring offers a safe and time-saving method for the jejuno-jejunal anastomosis in gastric cancer surgery, and for this purpose the ring has been approved as a standard method in our clinic. Nevertheless currently there are few studies on upper gastrointestinal sutureless anastomoses and this could be the reason for the low uptake of this device.

摘要

背景

可生物降解吻合环至今已用于胃肠道的各种吻合术,但尚未在外科医生中得到广泛认可。本回顾性研究的目的是比较胃癌患者中采用无缝合与缝合方法进行Roux - Y空肠空肠吻合术的手术效果。

方法

根据吻合技术将患者分为两组(无缝合组与手工缝合组):记录每位患者的围手术期结果。

结果

完成一次无缝合吻合术的平均时间为11±4分钟,而进行手工缝合吻合术的时间为23±7分钟。无缝合组估计术中失血量为178±32毫升,缝合方法组为182±23毫升,无显著差异。未记录到与肠吻合相关的并发症。两组术中均无死亡病例。

结论

可生物降解吻合环为胃癌手术中空肠空肠吻合提供了一种安全且节省时间的方法,为此该吻合环已在我们诊所被批准为标准方法。然而,目前关于上消化道无缝合吻合术的研究较少,这可能是该装置使用率低的原因。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/00c9/3499244/93b9d3a3246d/1471-2482-12-S1-S27-1.jpg

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