Ishizaki Tetsuo, Mazaki Junichi, Kasahara Kenta, Udo Ryutaro, Tago Tomoya, Nagakawa Yuichi
Department of Gastrointestinal and Pediatric Surgery, Tokyo Medical University, 6-7-1 Nishi-Shinjuku, Shinjuku-ku, Tokyo, 160-0023, Japan.
Tech Coloproctol. 2025 Jul 22;29(1):148. doi: 10.1007/s10151-025-03190-8.
In laparoscopic colectomy, overlap anastomosis (OA) is the most standard method of intracorporeal anastomosis. To avoid narrowing the anastomotic area, the closure of the enterotomy is often performed with handsewn running sutures of the monofilament. The purpose of this study was to compare two porcine in vitro colon models of stapled versus handsewn closure of enterotomy in intracorporeal OA.
In total, 40 porcine in vitro colon OA models (20 cases in the stapled closure, SC group, in which the enterotomy was closed with a stapler, and 20 cases in the handsewn closure with monofilament, HC group) were created, and anastomotic area with maximum intensity projection-computed tomography, anastomotic time, and leakage pressure were measured.
In the anastomotic area, there was no significant difference between in the SC group and HC group (474.0 ± 105.0 mm versus 502.6 ± 155.6 mm, p = 0.552). The anastomotic time was significantly shorter in the SC group than in the HC group (185.9 ± 38.3 s versus 292.4 ± 67.8 s, p < 0.001). The leakage pressure was significantly higher in the SC group than in the HC group (30.1 ± 3.8 mmHg versus 21.6 ± 5.3 mmHg, p < 0.001).
The findings of this study using porcine in vitro colon model showed that, in OA, the anastomotic area was similar, anastomotic time was significantly shorter, and leakage pressure was significantly higher in SC compared with HC. The results suggest that SC may be superior to HC when performing intracorporeal OA in laparoscopic surgery for colon cancer.
在腹腔镜结肠切除术中，重叠吻合术（OA）是最标准的体内吻合方法。为避免吻合口面积变窄，肠切开术的关闭通常采用单丝手工连续缝合。本研究的目的是比较两种猪体外结肠模型在体内OA中使用吻合器与手工缝合关闭肠切开术的效果。
总共创建了40个猪体外结肠OA模型（吻合器关闭组20例，即SC组，用吻合器关闭肠切开术；单丝手工缝合关闭组20例，即HC组），并测量了最大强度投影计算机断层扫描的吻合口面积、吻合时间和渗漏压力。
在吻合口面积方面，SC组和HC组之间无显著差异（474.0±105.0平方毫米对502.6±155.6平方毫米，p = 0.552）。SC组的吻合时间明显短于HC组（185.9±38.3秒对292.4±67.8秒，p < 0.001）。SC组的渗漏压力明显高于HC组（30.1±3.8毫米汞柱对21.6±5.3毫米汞柱，p < 0.001）。
本研究使用猪体外结肠模型的结果表明，在OA中，SC组与HC组相比，吻合口面积相似，吻合时间明显更短，渗漏压力明显更高。结果表明，在腹腔镜结肠癌手术中进行体内OA时，SC可能优于HC。
