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一项前瞻性多机构研究,评估镍钛合金加压吻合环(Biodynamix ColonRingTM)用于择期结直肠吻合术的临床结果。

A prospective multi-institutional study assessing clinical outcome with the NiTi compression anastomosis ring (Biodynamix ColonRingTM) in elective colorectal anastomoses.

作者信息

Khromov Yakov, Pliakos Ioannis, Ibrahim Matter, Zbar Andrew P, Sayfan Joel, Papavramidis Theodossis S

机构信息

Department of Surgery A, Haemek Medical Center, Afula, Israel.

出版信息

Hepatogastroenterology. 2013 May;60(123):522-7. doi: 10.5754/hge12014.

Abstract

BACKGROUND/AIMS: This 3-institution study assessed the short-term clinical outcome and safety profile of the NiTi Biodynamix ColonRingTM compression anastomosis in elective colorectal resection.

METHODOLOGY

A prospective, open-label, non-randomized trial was conducted at 3 separate institutions between October 2008 to October 2009 in patients undergoing elective colorectal resection with the Biodynamix ColonRingTM compression anastomosis ring, assessing technical factors in its operative use, immediate and short-term clinical outcome parameters (length of hospital stay, time to first passage of flatus and stool and to oral intake) and peri-operative complications including anastomotic failure or stenosis and wound infection.

RESULTS

Forty patients (22 females, mean age 65.9 years; range 36-83 years were included in the analysis with 14 cases being performed laparoscopically. The median duration of surgery was 120 minutes (range 60-456 minutes) with a mean anastomotic time of 14.8 minutes (range 1.75-50 minutes). The mean height of anastomosis from the anal verge was 18.2cm. The median time to passage of first flatus and first stool was 2.4 and 3.5 days, respectively with a mean hospital stay of 7.3 days. There was one postoperative death (unrelated to an anastomotic complication) with 2 anastomotic leaks (5%), 2 wound infections (5%) and no cases of early anastomotic stricture.

CONCLUSIONS

The compression anastomosis ColonRingTM handles easily with an acceptable clinical outcome following both laparoscopic and open use. The incidence of anastomotic and wound complications is comparable to conventional stapled technology.

摘要

背景/目的:这项三机构研究评估了在择期结直肠切除术中使用镍钛生物动力结肠环压缩吻合术的短期临床疗效和安全性。

方法

2008年10月至2009年10月期间,在3个独立机构对接受择期结直肠切除术并使用生物动力结肠环压缩吻合环的患者进行了一项前瞻性、开放标签、非随机试验,评估其手术使用中的技术因素、近期和短期临床疗效参数(住院时间、首次排气和排便时间以及开始经口进食时间)以及围手术期并发症,包括吻合口漏或狭窄以及伤口感染。

结果

40例患者(22例女性,平均年龄65.9岁;范围36 - 83岁)纳入分析,其中14例为腹腔镜手术。手术中位持续时间为120分钟(范围60 - 456分钟),平均吻合时间为14.8分钟(范围1.75 - 50分钟)。吻合口距肛缘的平均高度为18.2cm。首次排气和首次排便的中位时间分别为2.4天和3.5天,平均住院时间为7.3天。有1例术后死亡(与吻合口并发症无关),2例吻合口漏(5%),2例伤口感染(5%),无早期吻合口狭窄病例。

结论

压缩吻合结肠环在腹腔镜和开放手术使用后操作简便,临床疗效可接受。吻合口和伤口并发症的发生率与传统吻合器技术相当。

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