Hjortrup A, Nordkild P, Christensen T, Sjøntoft E, Kjaergaard J
Department of Surgical Gastroenterology, Bispebjerg Hospital, Copenhagen, Denmark.
Dis Colon Rectum. 1989 May;32(5):422-5. doi: 10.1007/BF02563696.
By performing a colorectal anastomosis, the risk of a serious clinical leakage is about 10 percent. On the basis of this, the current study described a combined fibrin adhesive-sutured anastomosis in the rectum performed with interrupted seromuscular sutures externally and fibrin adhesive in the mucosa-mucosa cleft internally. Ten dogs having combined anastomosis were compared with ten dogs having a two-layer sutured anastomosis in the rectum as a control. The median bursting strength in the rectum seven days after the operation was 280 mm Hg (range, 180 to 340 mm Hg) for the combined anastomosis and 260 mm Hg (range, 170 to 405 mm Hg) for the sutured anastomosis in the control group. Two anastomoses with two-layer sutured anastomosis had a leak demonstrated radiographically, while no leakage was demonstrated in the ten dogs with combined anastomosis. In conclusion, intraluminal applied fibrin adhesive may contribute to the security of the sutured rectum-anastomosis.
通过进行结直肠吻合术，严重临床渗漏的风险约为10%。基于此，本研究描述了一种直肠联合纤维蛋白粘合剂-缝合吻合术，外部采用间断浆肌层缝合，内部在黏膜-黏膜间隙使用纤维蛋白粘合剂。将10只进行联合吻合术的狗与10只进行直肠双层缝合吻合术的狗作为对照。联合吻合术组术后7天直肠的中位破裂强度为280毫米汞柱（范围为180至340毫米汞柱），对照组缝合吻合术的中位破裂强度为260毫米汞柱（范围为170至405毫米汞柱）。在双层缝合吻合术组中有两例吻合口经影像学检查显示有渗漏，而在10只进行联合吻合术的狗中未发现渗漏。总之，腔内应用纤维蛋白粘合剂可能有助于提高直肠缝合吻合术的安全性。
