Duell Jason R, Thieman Mankin Kelley M, Rochat Mark C, Regier Penny J, Singh Ameet, Luther Jill K, Mison Michael B, Leeman Jessica J, Budke Christine M
Veterinary Clinical Sciences, Oklahoma State University, Stillwater, Oklahoma.
Small Animal Clinical Sciences.
Vet Surg. 2016 Jan;45(1):100-3. doi: 10.1111/vsu.12428.
To determine the frequency of dehiscence of hand-sutured and stapled intestinal anastomoses in the dog and compare the surgery duration for the methods of anastomosis.
Historical cohort study.
Two hundred fourteen client-owned dogs undergoing hand-sutured (n = 142) or stapled (n = 72) intestinal anastomoses.
Medical records from 5 referral institutions were searched for dogs undergoing intestinal resection and anastomosis between March 2006 and February 2014. Demographic data, presence of septic peritonitis before surgery, surgical technique (hand-sutured or stapled), surgery duration, surgeon (resident versus faculty member), indication for surgical intervention, anatomic location of resection and anastomosis, and if dehiscence was noted postoperatively were retrieved. Estimated frequencies were summarized and presented as proportions and 95% confidence intervals (CI) and continuous outcomes as mean (95% CI). Comparisons were made across methods of anastomosis.
Overall, 29/205 dogs (0.14, 95% CI 0.10-00.19) had dehiscence, including 21/134 dogs (0.16, 0.11-0.23) undergoing hand-sutured anastomosis and 8/71 dogs (0.11, 0.06-0.21) undergoing stapled anastomosis. There was no significant difference in the frequency of dehiscence across anastomosis methods (χ(2), P = .389). The mean (95% CI) surgery duration of 140 minutes (132-147) for hand- sutured anastomoses and 108 minutes (99-119) for stapled anastomoses was significantly different (t-test, P < .001).
No significant difference in frequency of dehiscence was noted between hand- sutured and stapled anastomoses in dogs but surgery duration is significantly reduced by the use of staples for intestinal closure.
确定犬类中手工缝合和吻合器吻合肠吻合口裂开的频率，并比较两种吻合方法的手术时长。
回顾性队列研究。
214只接受客户委托的犬，其中142只接受手工缝合肠吻合术，72只接受吻合器吻合术。
检索了5家转诊机构2006年3月至2014年2月间接受肠切除吻合术的犬的病历。收集人口统计学数据、术前是否存在感染性腹膜炎、手术技术（手工缝合或吻合器吻合）、手术时长、外科医生（住院医生与教员）、手术干预指征、切除和吻合的解剖位置以及术后是否发现吻合口裂开。估计频率以比例和95%置信区间（CI）汇总呈现，连续结果以均值（95%CI）呈现。对不同吻合方法进行比较。
总体而言，205只犬中有29只（0.14，95%CI 0.10 - 0.19）发生吻合口裂开，其中接受手工缝合吻合术的134只犬中有21只（0.16，0.11 - 0.23），接受吻合器吻合术的71只犬中有8只（0.11，0.06 - 0.21）。不同吻合方法的吻合口裂开频率无显著差异（χ²，P = 0.389）。手工缝合吻合术的平均（95%CI）手术时长为140分钟（132 - 147），吻合器吻合术为108分钟（99 - 119），两者有显著差异（t检验，P < 0.001）。
犬类中手工缝合和吻合器吻合的吻合口裂开频率无显著差异，但使用吻合器进行肠闭合可显著缩短手术时长。
