Mulholland M W, Magallanes F, Quigley T M, Delaney J P
Dis Colon Rectum. 1983 Sep;26(9):586-9. doi: 10.1007/BF02552967.
Several surgical procedures have been proposed to interrupt continuity of the gut, without transection, by means of a row of staples. Using the dog, we investigated the functional and histologic results of incontinuity stapling of the gastric antrum, the small intestine, and the colon. After creation of an end antrostomy, ileostomy, or colostomy, a staple line was placed proximal to the stoma (TA 55-4.8 mm staples). Decompression of the bowel proximal to the staple line was accomplished by an enteric anastomosis. Separation of the staple closure was detected by intestinal contents exiting from the stoma. Animals were sacrificed at the time of disruption, and specimens were obtained for histologic examination. Three of five antral closures broke down at a mean of 19.6 days after operation. All five small-bowel staple lines opened at a mean of 12.4 days. Five of five colonic staple lines disrupted 13.0 days postoperatively. The staples pulled through the bowel wall without losing their "B" shaped configuration. Microscopic examination showed intact mucosa across the staple line, with no submucosa to submucosa healing. Staple lines in the undivided small bowel or colon disrupt after approximately two weeks, due to lack of fibrotic healing. Staple interruptions of the gastric antrum also disrupt, but with less regularity.
已经提出了几种外科手术方法，通过一排吻合钉来中断肠道的连续性，而不进行横断。我们以狗为实验对象，研究了胃窦、小肠和结肠不连续吻合钉合术的功能和组织学结果。在建立端侧胃窦造口术、回肠造口术或结肠造口术后，在造口近端放置吻合钉线（TA 55 - 4.8毫米吻合钉）。通过肠吻合术实现吻合钉线近端肠管的减压。通过造口处有肠内容物排出检测吻合钉闭合处的分离情况。在吻合钉闭合处破裂时处死动物，并获取标本进行组织学检查。五个胃窦吻合口中有三个在术后平均19.6天破裂。所有五个小肠吻合钉线均在术后平均12.4天裂开。五个结肠吻合钉线中有五个在术后13.0天破裂。吻合钉穿过肠壁，但其“B”形结构未改变。显微镜检查显示吻合钉线处黏膜完整，黏膜下层至黏膜下层未愈合。未切断的小肠或结肠中的吻合钉线在大约两周后会破裂，原因是缺乏纤维性愈合。胃窦的吻合钉中断处也会破裂，但规律性较差。
