Stapled versus hand sewn anastomoses in patients with small bowel injury: A changing perspective

被引:28
作者
Witzke, JD [1 ]
Kraatz, JJ [1 ]
Morken, JM [1 ]
Ney, AL [1 ]
West, MA [1 ]
Van Camp, JM [1 ]
Zera, TR [1 ]
Rodriguez, JL [1 ]
机构
[1] Univ Minnesota, Sch Med, Hennepin Cty Med Ctr, Dept Surg, Minneapolis, MN 55415 USA
来源
JOURNAL OF TRAUMA-INJURY INFECTION AND CRITICAL CARE | 2000年 / 49卷 / 04期
关键词
D O I
10.1097/00005373-200010000-00013
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
Introduction: Recent studies indicate that trauma patients with hollow viscus injuries requiring anastomosis who are managed with stapling have a higher rate of complications than do those in whom a hand-sewn anastomosis is used. We undertook this study to determine whether this finding applied to patients with small bowel trauma at our institution. Methods: Records of patients with small bowel injuries were retrospectively reviewed. Demographics, severity of injury, injury management, and outcome data were collected. Results: Patients who had their small bowel injuries managed by hand-sewn repair versus resection and stapled anastomosis demonstrated a nonsignificant decrease in overall complication rate (35% vs. 44%) and rate of intra-abdominal complication (10% vs. 18%). Yet the rate of intra-abdominal abscess formation was significantly lower with hand-sewn repair than with resection and stapled anastomosis (4% vs. 13%). However, when handsewn primary repairs were excluded from the analysis and injuries that required resection and either stapled or hand-sewn anastomosis were compared, there was a similar overall complication rate (41% vs. 41%) and rate of intra-abdominal complications (17% vs. 21%). Conclusion: The rate of intra-abdominal complications did not differ significantly between patients requiring small bowel resection and reanastomosis managed by either a stapled or hand-sewn technique. In our experience, surgical stapling devices appear to be safe for use in repairing traumatic small bowel injury.
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页码:660 / 665
页数:6
相关论文
共 10 条
[1]   STAPLES OR SUTURES FOR COLONIC ANASTOMOSES - A CONTROLLED CLINICAL-TRIAL [J].
BRENNAN, SS ;
PICKFORD, IR ;
EVANS, M ;
POLLOCK, AV .
BRITISH JOURNAL OF SURGERY, 1982, 69 (12) :722-724
[2]   Stapled versus sutured gastrointestinal anastomoses in the trauma patient [J].
Brundage, SI ;
Jurkovich, GJ ;
Grossman, DC ;
Tong, WC ;
Mack, CD ;
Maier, RV .
JOURNAL OF TRAUMA-INJURY INFECTION AND CRITICAL CARE, 1999, 47 (03) :500-507
[3]   STAPLED GASTROINTESTINAL-TRACT ANASTOMOSIS - INCIDENCE OF POST-OPERATIVE COMPLICATIONS COMPARED WITH SUTURED ANASTOMOSIS [J].
CHASSIN, JL ;
RIFKIND, KM ;
SUSSMAN, B ;
KASSEL, B ;
FINGARET, A ;
DRAGER, S ;
CHASSIN, PS .
ANNALS OF SURGERY, 1978, 188 (05) :689-696
[4]   NEW TECHNIQUES OF GASTRO-INTESTINAL ANASTOMOSES WITH THE EEA STAPLER [J].
NANCE, FC .
ANNALS OF SURGERY, 1979, 189 (05) :587-600
[5]   TECHNIQUES OF STAPLE SUTURING IN GASTROINTESTINAL TRACT [J].
RAVITCH, MM ;
STEICHEN, FM .
ANNALS OF SURGERY, 1972, 175 (06) :815-+
[6]  
RAVITCH MM, 1959, SURGERY, V46, P97
[7]   PROSPECTIVE CONTROLLED-STUDY OF GASTROINTESTINAL STAPLED ANASTOMOSES [J].
REILING, RB ;
REILING, WA ;
BERNIE, WA ;
HUFFER, AB ;
PERKINS, NC ;
ELLIOTT, DW .
AMERICAN JOURNAL OF SURGERY, 1980, 139 (01) :147-152
[8]  
SCHER KS, 1982, SURG GYNECOL OBSTET, V155, P489
[9]   MECHANICAL SUTURES IN SURGERY [J].
STEICHEN, FM ;
RAVITCH, MM .
BRITISH JOURNAL OF SURGERY, 1973, 60 (03) :191-197
[10]  
*W SCOTL HIGHL AN, BR J SURG, V78, P377