Gross E, Köppen H O
I. Chirurgische Abteilung, Allgemeines Krankenhaus Hamburg-Barmbek.
Zentralbl Chir. 1993;118(8):459-65.
According to own experimental studies with anastomoses without any foreign material and based on the first clinical experience with the sutureless compression anastomoses (AKA-2) in colorectal surgery on 140 patients, this anastomotic technique was applied on further 147 patients following resections of the distal colon and rectum. Excluding the 24 patients with primary protective colostomy the leakage rate was 4.0% and out of the 45 patients with an anastomosis of 10 cm or less 2 patients developed fistulae (4.4%). 3 patients showed clinically inapparent fistulae by the routinely performed gastrographin enema. On endoscopy between 2nd and 3rd postoperative week no epithelial defects were found. Due to the biological advantages regarding morphological and functional criterias and a possible oncological advantage the sutureless compression anastomoses (AKA-2) can be recommended.
根据自身关于无任何异物吻合的实验研究,并基于结直肠手术中140例患者使用无缝合压缩吻合术(AKA - 2)的首次临床经验,该吻合技术在另外147例远端结肠和直肠切除术后的患者中应用。排除24例行一期保护性结肠造口术的患者,渗漏率为4.0%,在45例吻合口长度为10 cm或更短的患者中,有2例发生瘘(4.4%)。3例患者通过常规进行的泛影葡胺灌肠显示有临床不明显的瘘。术后第2周和第3周的内镜检查未发现上皮缺损。鉴于在形态学和功能标准方面的生物学优势以及可能的肿瘤学优势,无缝合压缩吻合术(AKA - 2)值得推荐。