Thiede A, Jostarndt L, Troidl H, Poser H L, Bertz U, Hamelmann H
Chirurg. 1981 Jan;52(1):30-5.
A prospective study was carried out on 91 patients to evaluate colonic and rectal anastomoses constructed with an EEA stapling gun. The concept comprises the following: orthograde lavage, cecal fistula or colostomy, intraoperative sufficiency control of the anastomosis, intraoperative direct measurement of the height of the anastomosis, postoperative X-ray control of the anastomosis using standardized techniques, classification of the cases into three groups according to the height of the anastomosis: 3-5 cm, and over 9 cm. Characterization of the patients was accomplished biostatistically using the Median-Quartil system. Primary hospital letality of 2% was due to heart failure. Imparied wound healing occurred in 11%. Secondary suture dehiscence was roentgenologically identified in a total of 18% of which only 7% showed clinical symptoms. Stenosis was determined by X-ray in 11% with only 1% demonstrating a temporary clinical correlation. For especially low rectal anastomoses at 3-5 cm the EEA stapling gun appears to have a great technical advantage over hand-placed sutures, allowing extension of indications for low anastomoses.
对91例患者进行了一项前瞻性研究，以评估使用EEA吻合器构建的结肠和直肠吻合术。该概念包括以下内容：顺行灌洗、盲肠造瘘或结肠造口术、术中对吻合口进行充分性控制、术中直接测量吻合口高度、术后使用标准化技术对吻合口进行X线检查、根据吻合口高度将病例分为三组：3 - 5厘米、以及超过9厘米。使用中位数-四分位数系统通过生物统计学方法对患者进行特征描述。2%的原发性医院死亡率归因于心力衰竭。11%的患者出现伤口愈合不良。通过X线检查总共发现18%的患者出现继发性缝线裂开，其中只有7%表现出临床症状。X线检查确定11%的患者存在狭窄，只有1%表现出暂时的临床相关性。对于3 - 5厘米处特别低位的直肠吻合术，EEA吻合器似乎比手工缝合具有很大的技术优势，从而扩大了低位吻合术的适应症范围。
