Julian T B, Ravitch M M
Ann Surg. 1986 Aug;204(2):186-92. doi: 10.1097/00000658-198608000-00014.
Stapling is widely accepted in the field of pulmonary and gastrointestinal surgery. However, this has not been the case in urinary tract surgery, presumably because of the possibility of stone formation on the staples. In addressing the issue, both stainless steel staples and absorbable staples (PolysorbTM) were evaluated in 104 linear stapled closures of dog bladders. The mucosa to mucosa closures were performed in bladders with sterile, acutely infected, and chronically infected urine. Staple lines were resected and examined both grossly and microscopically at periods from 1 week to 4 months after the closures. No animal suffered a clinical leak or abscess formation. Four steel closures developed exposed staples, one of which developed a small amount of crystal formation. Twenty-nine absorbable closures contained exposed staples in which two closures developed crystal formation. All closures were secure and healed without difficulty. It appears that closure of the bladder with stainless or absorbable staples is safe and effective.
吻合器在肺部和胃肠外科领域已被广泛接受。然而,在泌尿外科手术中情况并非如此,推测是因为吻合钉上可能形成结石。为解决这一问题,在对犬膀胱进行的104例线性吻合钉闭合术中,对不锈钢吻合钉和可吸收吻合钉(PolysorbTM)都进行了评估。在尿液无菌、急性感染和慢性感染的膀胱中进行黏膜对黏膜的闭合。在闭合术后1周~4个月期间,切除吻合钉线并进行大体和显微镜检查。没有动物出现临床漏尿或脓肿形成。4例使用不锈钢吻合钉的闭合术出现吻合钉外露,其中1例出现少量晶体形成。29例使用可吸收吻合钉的闭合术有吻合钉外露,其中2例出现晶体形成。所有闭合均牢固,愈合顺利。看来,使用不锈钢或可吸收吻合钉闭合膀胱是安全有效的。