Marchena Gómez J, Ruiz de la Cuesta E, Gómez Guerra G, Vallejo Gallego I, García-Anguíano F, Hernández Romero J M
Servicio de Ciruía General y Digestiva. Hospital Universitario Ntra. Sra. del Pino. Las Palmas de Gran Canaria.
Rev Esp Enferm Dig. 1997 Nov;89(11):835-42.
Analysis of colorectal anastomosis stricture incidence after anterior resection of the rectum performed with the EEA-Stapler. To find out if differences existed in stricture incidence considering factors such, as age, neoplasia, postoperative radiotherapy, tumor stage and anastomic level.
Longitudinal descriptive study.
67 patients who underwent rectal anterior resection using the EEA-Stapler were evaluated. Data from sex, age, indication for operation, postoperative radiotherapy, tumor staging and anastomic level were recorded and compared with presence of stricture anastomosis. Stenosis was evaluated and graded as follows: grade O, no stenosis; grade I, no symptoms, X-ray or endoscopic finding; grade II, symptoms, the patients require ballon catheter dilation; and grade III, invalidant symptoms, the patients require surgery.
Twelve patients (20%) were recorded as grade II and 3 patients (5%) as grade III. There were no statistically significant differences between prevalence of stricture and sex, age, neoplasic or non-neoplasic conditions, previous radiotherapy, level of anastomosis, and tumor stage.
Stenosis after colorectal anastomosis with stapler devices must not be considered as an uncommon complication. In 20% of patients it may be a serious state that may require repeated catheter balloon dilations or surgery. Such condition is not dependent on diverse factors studied.
分析使用EEA吻合器行直肠前切除术后结直肠吻合口狭窄的发生率。探究在考虑年龄、肿瘤、术后放疗、肿瘤分期及吻合平面等因素时,狭窄发生率是否存在差异。
纵向描述性研究。
对67例行直肠前切除并使用EEA吻合器的患者进行评估。记录性别、年龄、手术指征、术后放疗、肿瘤分期及吻合平面等数据,并与吻合口狭窄情况进行比较。狭窄评估及分级如下:0级,无狭窄;I级,无症状,X线或内镜检查无异常发现;II级,有症状,患者需行球囊导管扩张;III级,症状严重,患者需手术治疗。
12例患者(20%)被记录为II级,3例患者(5%)为III级。狭窄发生率与性别、年龄、肿瘤或非肿瘤情况、既往放疗、吻合平面及肿瘤分期之间无统计学显著差异。
使用吻合器进行结直肠吻合术后的狭窄不应被视为罕见并发症。在20%的患者中,这可能是一种严重情况,可能需要反复进行球囊导管扩张或手术。这种情况不依赖于所研究的各种因素。