Luukkonen P, Järvinen H
Department of Surgery, University Central Hospital, Helsinki, Finland.
Arch Surg. 1993 Apr;128(4):437-40. doi: 10.1001/archsurg.1993.01420160075012.
A prospective, randomized study of hand-sutured (group 1, n = 19) and double-stapled (group 2, n = 21) ileoanal anastomosis was carried out in 40 consecutive patients during restorative proctocolectomy to compare complications and functional outcome. Eight patients (42%) in group 1 and 12 (57%) in group 2 had one or more complications. Four patients in group 1 and five in group 2 developed pelvic sepsis. One stapled anastomosis had to be converted to a hand-sutured one because of severe anastomotic stricture. Four patients in group 1 and eight in group 2 had no nighttime evacuations 3 months after surgery and seven patients in group 1 and 11 in group 2 had no nighttime evacuations six months after surgery. Mucous leakage occurred in two vs five patients after 6 months in groups 1 and 2, respectively. The mean resting anal pressure decreased 30% in group 1 and 28% in group 2. In conclusion, double-stapled ileoanal anastomosis does not offer any functional or technical advantage over hand-sutured anastomosis, but it does leave some of the disease behind.
对40例连续行保留肛门的直肠结肠切除术患者进行了前瞻性随机研究，比较手工缝合（第1组，n = 19）和双吻合器技术（第2组，n = 21）行回肠肛管吻合术的并发症及功能结果。第1组8例（42%）和第2组12例（57%）出现一种或多种并发症。第1组4例和第2组5例发生盆腔感染。1例双吻合器吻合因严重吻合口狭窄转为手工缝合。术后3个月，第1组4例、第2组8例无夜间排便；术后6个月，第1组7例、第2组11例无夜间排便。术后6个月，第1组2例、第2组5例发生黏液漏。第1组静息肛管压力平均下降30%，第2组下降28%。总之，双吻合器回肠肛管吻合术在功能或技术上并不优于手工缝合吻合术，但会残留部分病变。
