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

[11]

Rodary M., Fingerhut A., Hay J.M., Povidone-iodine enemas and one-day antibiotic prophylaxis: A continuous search for the ideal bowel preparation for elective colonic surgery. A multicenter controlled trial, Colo proctology, 13, pp. 5-12, (1991)

[12]

Trials and tribulations: Thoughts on the organization of multicentre clinical studies, Br Med J, 281, pp. 918-920, (1980)

[13]

Evans M., Pollack A.V., Trials on trial. A review of trials on antibiotic prophylaxis, Arch Surg, 119, pp. 109-113, (1984)

[14]

Schwartz D., Flamant R., Lellouch J., Clinical trials, (1980)

[15]

Murray G.D., Statistical aspects of research methology, Br J Surg, 78, pp. 777-781, (1991)

[16]

Lorentz F.H., Ein neuer Konstitutionsindex, Klin Wochenschr, 16, pp. 348-351, (1929)

[17]

Goligher J., Graham N.G., De Dombal F.T., Anastomotic dehiscence after anterior resection of rectum and sigmoid, Br J Surg, 57, pp. 109-118, (1979)

[18]

Scher K.S., Scott-Connor C., Jones C.W., Leach M., A comparison of stapled and sutured anastomoses in colonic operations, Surg Gynecol Obstet, 155, pp. 489-493, (1982)

[19]

Suturing or stapling in gastrointestinal surgery: a prospective randomized study, Br J Surg, 78, pp. 337-341, (1991)

[20]

Solomkin J.S., Dellinger E.P., Christou N.V., Mason A.D., Design and conduct of antibiotic trials. A report of the Scientific Studies Committee of the Surgical Infection Society, Arch Surg, 122, pp. 158-164, (1987)

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