ILEOCOLONIC ANASTOMOSIS AFTER RIGHT HEMICOLECTOMY FOR CARCINOMA - STAPLED OR HAND-SEWN - A PROSPECTIVE, MULTICENTER, RANDOMIZED TRIAL

被引：78

作者：

KRACHT, M ^{[1
]}

HAY, JM ^{[1
]}

FAGNIEZ, PL ^{[1
]}

FINGERHUT, A ^{[1
]}

机构：

[1] ARC,8 AVE PEULIERS,F-92270 BOIS COLOMBES,FRANCE

来源：

INTERNATIONAL JOURNAL OF COLORECTAL DISEASE | 1993年 / 8卷 / 01期

关键词：

D O I：

10.1007/BF00341273

中图分类号：

R57 [消化系及腹部疾病];

学科分类号：

摘要：

440 patients were prospectively enrolled in a randomized, multicenter trial to compare 4 types of manual (84 interrupted end-to-end, 77 continuous end-to-end, 82 interrupted end-to-side, and 91 continuous end-to-side) (polyglycolic derived suture) and 1 type of stapled (106 side-to-side with GIA + TA devices) ileocolonic anastomosis after right hemicolectomy for carcinoma. The trial was designed according to Schwartz' pragmatic formulation. All 5 groups were well-matched, except for a lower rate of intraoperative sepsis in the stapled group (P < 0.02). The main end point was anastomotic leakage detected clinically or by routine sodium diatrizoate enema on the 8-10th postoperative day. Results showed that stapled ileocolonic anastomosis was associated with less anastomotic leakages (2.8 %) than all the other techniques combined (8.3 %). In spite of the fact that staples are approximately ten times more expensive, our results suggest performing side-to-side (GIA + TA) mechanical anastomosis after right resection for carcinoma.

引用

页码：29 / 33

页数：5

共 20 条

[1]

Chassin J.L., Rifkind K.M., Sussmann B., The stapled gastrointestinal tract anastomosis

[2]

incidence of postoperative complications compared with the sutured anastomosis, Ann Surg, 188, pp. 689-696, (1978)

[3]

Steichen F.M., The use of staplers in anatomical side-to-side and functional end-to-end anastomoses, Surgery, 64, pp. 948-953, (1968)

[4]

Steichen F.M., Ravitch M.M., Mechanical sutures in surgery, Br J Surg, 70, pp. 191-197, (1973)

[5]

Adloff M., Turbelin J.M., Hémicolectomie droite avec anastomose colo-iléale “première”. Modifications apportées par les procédés de suture mécanique, Nouv Press Med, 1, pp. 1075-1077, (1982)

[6]

Brodman R.F., Brodman H.R., Staple suturing of the colon above the peritoneal reflection, Arch Surg, 11, pp. 191-192, (1981)

[7]

Brennan S.S., Pickford I.R., Evans M., Pollock A.V., Staples or sutures for colonic anastomoses—A controlled clinical trial, Br J Surg, 69, pp. 722-724, (1982)

[8]

Everett W.G., Friend P.J., Forty J., Comparison of stapling and hand-suture for left-sided large bowel anastomosis, Br J Surg, 73, pp. 345-348, (1986)

[9]

Rodary M., Hay J.M., Fingerhut A., Oberlin P., Conventional mechanical preparation versus whole-gut irrigation for elective colonic resection: a multicentric prospective controlled trial, Colo proctology, 9, pp. 87-93, (1987)

[10]

Rodary M., Fingerhut A., Hay J.M., Mechanical and antibiotic preparation of the bowel for elective colorectal surgery. Three-day versus oneday preparation, Colo proctology, 5, pp. 271-276, (1988)

← 1 2 →