Chassin J L, Rifkind K M, Sussman B, Kassel B, Fingaret A, Drager S, Chassin P S
Ann Surg. 1978 Nov;188(5):689-96. doi: 10.1097/00000658-197811000-00019.
Performance of gastrointestinal anastomosis by means of surgical stapling devices has achieved popularity in the last decade even though no detailed study has been reported comparing complications following the stapled anastomosis with those following hand sutured procedures performed by the same surgeons. We have reviewed 812 operative procedures on the gastrointestinal tract performed in one hospital over a four year period. Stapled anastomoses were performed in 472 with 13 (2.8%) complications related to the anastomosis; in 296 sutured anastomoses there were nine (3.0%) related complications. Comparison did not disclose any significant difference in the number of complications in these two groups. In 44 instances wherein the anastomosis contained both staples and sutures, there were no related complications. Further analysis of the patients in each group disclosed that stapling procedures were utilized in a much higher percentage of those operations which were performed under emergency conditions or in the presence of intra-abdominal sepsis, intestinal obstruction, and carcinomatosis. If the technical details of surgical stapling are mastered, this technique appears to be as safe as suturing in the performance of anastomoses in the gastrointestinal tract.
尽管尚无详细研究报告比较使用外科吻合器进行胃肠道吻合术后的并发症与同一外科医生进行手工缝合术后的并发症，但在过去十年中，使用外科吻合器进行胃肠道吻合术已变得很普遍。我们回顾了一家医院在四年期间进行的812例胃肠道手术。472例采用吻合器吻合，其中13例（2.8%）出现与吻合相关的并发症；296例采用手工缝合吻合，有9例（3.0%）出现相关并发症。比较结果显示这两组的并发症数量没有显著差异。在44例吻合术中既有吻合钉又有缝线的情况下，未出现相关并发症。对每组患者的进一步分析表明，在急诊情况下或存在腹腔内感染、肠梗阻和癌转移的手术中，使用吻合器吻合的比例要高得多。如果掌握了外科吻合器的技术细节，那么在胃肠道吻合术中，这项技术似乎与缝合一样安全。
