McCue J L, Phillips R K
Professorial Surgical Unit, St. Bartholomew's Hospital, London, United Kingdom.
Dis Colon Rectum. 1993 May;36(5):468-74. doi: 10.1007/BF02050013.
Elevated cellular proliferation in the vicinity of an anastomosis may explain the enhanced susceptibility to carcinogens. The aim of this study was to determine whether anastomotic cellular proliferation was altered by different suture materials and whether a rise in cell turnover also occurred after a "sutureless" closure. A transverse descending colon enterotomy was repaired with interrupted sutures of 5/0 silk (n = 20), stainless steel (n = 20), or Vicryl (Ethicon, Inc., Somerville, NJ) (n = 20) or by a sutureless technique (n = 20). Using a stathmokinetic technique, crypt cell production rates (CCPR) were calculated at the anastomosis and in the adjacent colon at varying intervals between one week and six months after treatment. Overall colonic cellular proliferation appeared to be elevated at a sutured colotomy for at least three months (P < 0.05). In contrast, no significant elevation in cellular proliferation was observed at sutureless anastomoses. The duration of elevated proliferative response varied among the sutures.
吻合口附近细胞增殖增加可能解释了对致癌物易感性增强的原因。本研究的目的是确定不同缝合材料是否会改变吻合口细胞增殖，以及“无缝合”闭合后细胞更新率是否也会升高。对横断降结肠肠切开术分别采用5/0丝线间断缝合（n = 20）、不锈钢线间断缝合（n = 20）、薇乔缝线（Ethicon公司，新泽西州萨默维尔）间断缝合（n = 20）或无缝合技术（n = 20）进行修复。采用静止期动力学技术，在治疗后1周和6个月之间的不同时间间隔计算吻合口处和相邻结肠的隐窝细胞生成率（CCPR）。在缝合的结肠切开处，总的结肠细胞增殖至少在3个月内似乎有所升高（P < 0.05）。相比之下，在无缝合吻合口处未观察到细胞增殖有显著升高。不同缝线的增殖反应升高持续时间有所不同。
