Massi G, Brocato R, Maurizi G, Truosolo B, Forti A, Nigita G
Casa di cura Clinica di Chirurgia Addominale all'Eur, U.S.L. RM 07, Roma.
Ann Ital Chir. 1993 May-Jun;64(3):315-8.
The device invented in 1892 by Murphy is now being used again: as a matter of fact, modern technologies allowed for the development of a pressure bowel-anastomosis system with complete reabsorption, whose mechanical structure resembles Murphy's device. In 1987, in digestive anastomosis, the B.A.R. (Bowel Anastomosis Ring) pressure suturing device was successfully used. In this case report, the authors, on the basis of previous experiences concerning pressure bowel anastomosis with biodegradable material, describe the use of the B.A.R. for the performance of an ileo-rectal sub-peritoneal anastomosis in a patient with rectal neoplasia and previous ileorectostomy. In the authors' opinion, the absence of post-surgery complications and the very good functional outcome that was achieved in such a complex case, from a pathological and surgical point of view, is a further contribution to the validity of such methodology, which is also supported by several studies carried out both in the U.S.A. and in Europe on colic and upper digestive surgery. By overcoming the last hindrance represented by the performance of esophageal anastomosis, it will be possible to consider B.A.R. as a useful and proper method to be generally applied in digestive surgery.
墨菲于1892年发明的装置如今又被重新使用:事实上,现代技术促成了一种具有完全重吸收功能的压力性肠吻合系统的开发,其机械结构类似于墨菲的装置。1987年,在消化吻合术中,B.A.R.(肠吻合环)压力缝合装置被成功使用。在本病例报告中,作者基于先前使用可生物降解材料进行压力性肠吻合的经验,描述了在一名患有直肠肿瘤且先前接受过回直肠吻合术的患者中使用B.A.R.进行回直肠腹膜下吻合的情况。作者认为,从病理学和手术学角度来看,在这样一个复杂病例中未出现术后并发症且取得了非常好的功能结果,这进一步证明了该方法的有效性,美国和欧洲针对结肠和上消化道手术开展的多项研究也支持这一点。通过克服食管吻合术这一最后障碍,将有可能把B.A.R.视为一种可普遍应用于消化手术的有用且合适的方法。