Hanson R R, Nixon A J, Calderwood-Mays M, Gronwall R, Pendergast J F
Department of Surgical Sciences, College of Veterinary Medicine, University of Florida, Gainesville 32610.
Am J Vet Res. 1988 Sep;49(9):1621-8.
Two techniques for end-to-end anastomosis of the small colon were evaluated in each of 6 horses. A simple interrupted suture pattern that excluded the mucosa and was oversewn with an inverting suture was compared with a triangulated double-row pattern of stainless steel staples. Anastomotic sites were evaluated at 2 weeks, 2 months, and 6 months for extent of abdominal adhesions, lumen diameter at anastomotic sites, bursting pressures, and healing response. Clinical postoperative complications were not associated with either technique. At postmortem examination, there was extensive adhesion formation from the mesocolon to the stapled anastomotic site. The suture technique resulted in greater luminal diameters (P less than or equal to 0.05), with good apposition of the tissue layers. Staples were missing as early as 2 weeks after surgery, and their loss was associated with separation of the muscularis at later evaluation periods. Regardless of technique, all but one anastomotic segment burst away from the anastomotic site along the mesenteric taenial band. For the 12 anastomoses performed in normal horses, the suturing technique was better than the stapling technique because of significantly larger lumen diameters, better anastomotic healing, and minimal intra-abdominal adhesion formation.
在6匹马中，对两种小结肠端端吻合技术进行了评估。将一种简单的间断缝合方式（排除黏膜并用内翻缝合线缝合）与不锈钢吻合钉的三角形双排缝合方式进行比较。在术后2周、2个月和6个月对吻合部位进行评估，观察腹部粘连程度、吻合部位的管腔直径、破裂压力和愈合反应。两种技术均未引发临床术后并发症。在尸检时，发现从结肠系膜到吻合钉吻合部位有广泛的粘连形成。缝合技术使管腔直径更大（P小于或等于0.05），组织层贴合良好。术后仅2周就有吻合钉缺失，在后期评估时，吻合钉的缺失与肌层分离有关。无论采用何种技术，除一个吻合段外，所有吻合段均沿肠系膜带从吻合部位破裂。对于在正常马匹中进行的12次吻合，缝合技术优于吻合钉技术，因为其管腔直径明显更大、吻合口愈合更好且腹腔内粘连形成最少。
