Ceraldi C M, Rypins E B, Monahan M, Chang B, Sarfeh I J
Department of Surgery, University of California, Irvine.
Am Surg. 1993 Mar;59(3):168-71.
The documented leak rate of the continuous single layer polypropylene (CSLP) anastomosis in elective colon resection is 0-6 per cent. It is more cost effective than stapling (S), and should be faster and easier to perform than the double-layer (DL) technique. However, there have been no reported series comparing the outcome of the CSLP anastomosis with the DL and S techniques. We reviewed the charts of 100 patients with elective colon resections. Eighty-four had data sufficient for analysis. There were 44 CSLP, 21 DL, and 19 S. The groups were comparable with respect to 12 preoperative variables. Proportionately more large-small bowel anastomoses were performed in the S group, and no patient in the S group was actively taking steroids. Clinical outcome was assessed. All leaks were clinically apparent and documented with contrast enema or laparotomy. The leak rate for the CSLP was 6.8 per cent (3/44). Two of the three patients with leaks were taking steroids. There were two leaks in the DL group (9.5%), one of which was taking steroids, and no leaks in the S group. The difference in leak rate between the three groups was not statistically significant. The average cost for CSLP at our institution is $4.00 compared with $8.00 and $35.00 for the DL and S, respectively. We conclude that the CSLP is a reasonable and safe alternative to DL and S anastomoses.
择期结肠切除术中连续单层聚丙烯（CSLP）吻合术的文献报道漏率为0%至6%。它比吻合器吻合术（S）更具成本效益，并且应该比双层（DL）技术实施起来更快、更容易。然而，尚无报道系列比较CSLP吻合术与DL和S技术的结果。我们回顾了100例择期结肠切除患者的病历。84例有足够的数据用于分析。其中44例采用CSLP，21例采用DL，19例采用S。这三组在12个术前变量方面具有可比性。S组进行大肠-小肠吻合的比例更高，且S组没有患者正在积极服用类固醇。评估了临床结果。所有漏口在临床上都很明显，并通过造影灌肠或剖腹手术记录下来。CSLP的漏率为6.8%（3/44）。3例发生漏口的患者中有2例正在服用类固醇。DL组有2例漏口（9.5%），其中1例正在服用类固醇，S组无漏口。三组之间的漏率差异无统计学意义。在我们机构，CSLP的平均成本为4美元，而DL和S分别为8美元和35美元。我们得出结论，CSLP是DL和S吻合术合理且安全的替代方法。
