Tonus C, Böckmann U, Nier H
Chirurgische Klinik I, Klinik für Allgemein-, Gefäss- und Thorax-Chirurgie, J.-W.-Goethe-Universität Frankfurt am Main.
Chirurg. 1996 Mar;67(3):249-53.
The main observation criterion of the present retrospective study is the insufficiency rate after machine closing of the duodenal stump (TA-clip seam device, Auto-Suture), as a consequence of gastrectomy, resection of the stomach with Billroth II respective Roux-Y reconstruction, depending on the used type of clip. Between January 1, 1985 and October 2, 1989 the closing of the duodenal stump was routinely carried out with metal clips (n = 253) in the City Hospital Offenbach. Between October 3, 1989 and December 31, 1991 polysorb staples (n = 96) were exclusively used. The patient collectives were comparable regarding age, sex, health status, basic diseases, accompanying diseases and surgical methods. Closing of the duodenal stump by polysorb staples demonstrated with 13.5% more dehiscent seams than with metal clips (4.7%). As a result of the present study, we cannot recommend the use of polysorb clips for the closing of the duodenal stump.
本回顾性研究的主要观察标准是胃切除术后十二指肠残端机械闭合(TA夹缝合装置,自动缝合)后的不足率,胃切除是指根据所使用夹子的类型,采用毕罗Ⅱ式或Roux-Y重建法切除胃。1985年1月1日至1989年10月2日期间,奥芬巴赫市立医院常规使用金属夹闭合十二指肠残端(n = 253)。1989年10月3日至1991年12月31日期间,仅使用了聚乙醇酸缝合钉(n = 96)。患者群体在年龄、性别、健康状况、基础疾病、伴随疾病和手术方法方面具有可比性。使用聚乙醇酸缝合钉闭合十二指肠残端的裂开缝合率比使用金属夹高13.5%(4.7%)。根据本研究结果,我们不建议使用聚乙醇酸夹闭合十二指肠残端。