Abstract
To determine the results of our experience with the use of staples for construction of anastomoses following colonic resection, a series of 223 anastomoses performed in 205 patients was reviewed. Indications for operation included malignancy, benign neoplasms, inflammatory bowel disease, and several miscellaneous entities. A functional end-to-end anastomosis using the standard GIA cartridge and the TA 55 instruments was performed. The operative mortality was 1.5% with none of the deaths related to the anastomosis. Intraoperative complications encountered included bleeding (21), leak (1), tissue fracture (1), instrument failure (4), and technical error (3). Early postoperative complications related or potentially related to the anastomosis included bleeding (5), pelvic abscess (1), fistula (1), peritonitis (2), ischemia of anastomosis (1). Late complications included five patients with small bowel obstruction, two of whom required operation. Anastomotic recurrences developed in 5.9% of patients. Our experience gained with stapling instruments has shown them to be a reliable method for performing anastomoses in the colon in a safe and expeditious manner.
Résumé
Pour detérminer les résultats de notre expérience avec l'utilisation de pinces automatiques pour la construction des anastomoses après résection colique, une série de 223 anastomoses effectueés chez 205 malades a été revue. Les indications opératoires incluaient les tumeurs malignes, les tumeurs bénignes, les maladies inflammatoires du colon et plusieurs affections varieés. Une anastomose termino-terminale utilisant la pince standard GIA et la pince TA 55 a été exécuteé. La mortalite ópératoire fût de 1,5% sans aucune mort en relation avec l'anastomose. Les complications intra-opératoires rencontreés comprenaient des hémorragies (21), une fistule (1), une brèche tissulaire (1), des defauts d'instrumentation (4) et des erreurs techniques (3). Les complications post-opératoires précoces en relation ou potentiellement en relation avec l'anastomose comportait des hémorragies (5), un abcés pelvien (1), une fistule (1), des péritonites (2), une ischémie de l'anastomose (1). Les complications tardives comprenaient 5 patients avec une occlusion post-opératoire dont 2 ont nécessité une opération. Les récidives anastomotiques apparûrent chez 5,9% des patients. Notre expérience de l'utilisation des pinces automatiques à suture a montré qu'il s'agit d'une méthode fiable pour pratiquer les anastomoses du colon d'une façon sure et rapide.
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Kyzer, S., Gordon, P.H. The stapled functional end-to-end anastomosis following colonic resection. Int J Colorect Dis 7, 125–131 (1992). https://doi.org/10.1007/BF00360351
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DOI: https://doi.org/10.1007/BF00360351