التفاصيل البيبلوغرافية
| العنوان: |
Comparative surgical and colonoscopic appearance of colon anastomoses constructed with sutures, staples, and the biofragmentable anastomotic ring. |
| المؤلفون: |
Bundy, Charles, Zera, Richard, Onstad, Gerald, Bilodeau, Laura, Bubrick, Melvin, Bundy, C A, Zera, R T, Onstad, G A, Bilodeau, L L, Bubrick, M P |
| المصدر: |
Surgical Endoscopy; Jan1992, Vol. 6 Issue 1, p18-22, 5p |
| مصطلحات موضوعية: |
COLON surgery, SURGICAL anastomosis, ANIMAL experimentation, COLON (Anatomy), COLONOSCOPY, COMPARATIVE studies, DOGS, HEMATOMA, RESEARCH methodology, MEDICAL cooperation, RESEARCH, STAPLERS (Surgery), SURGICAL complications, SUTURES, EVALUATION research, EQUIPMENT & supplies, DIAGNOSIS |
| مستخلص: |
Unlabelled: The following animal study was undertaken to compare and assess the endoscopic gross appearance and histology of colonic anastomoses constructed with sutures, staples, and the biofragmentable anastomotic ring (BAR).Methods: Three anastomoses--1 BAR, 1 stapled, and 1 sutured--were placed in each of 48 dogs and colonoscopy and anastomotic evaluation were done.Results: No leaks were found by air insufflation at surgery. Grossly, the BAR had serosal hematomas in 27/48 anastomoses vs 7/48 for stapled and 1/48 for sutured (BAR vs stapled P < 0.0005 and sutured vs stapled P = 0.07). Adhesions were significantly greater for BAR (35/36) and sutured (34/36) compared to stapled (26/36) (BAR vs stapled P = 0.01 and sutured vs. stapled P = 0.04). Colonoscopic exams at days 3, 7, and 28 showed no significant difference among groups with respect to bleeding, ulceration, necrosis, granulation, or contour. Sutured anastomoses were more stenotic (24/31) than stapled (4/31) or BAR (3/31) ones (BAR vs sutured and sutured vs stapled P < 0.005). At 28 days, 10/10 sutured vs 2/10 stapled vs 3/10 BAR were stenotic (BAR vs sutured P = 0.02, sutured vs stapled P = 0.01). Inflammation on histologic exam at 28 days was not significantly different: sutured (12/12), stapled (12/12), or BAR (9/12). Fibrosis was more prominent in sutured (12/12) than in stapled (5/12) or BAR (4/12) anastomoses (BAR vs sutured P = 0.001, sutured vs stapled P = 0.004, and BAR vs stapled P = 1.00). All anastomoses healed primarily without necrosis or obstruction.Conclusions: (1) Colonoscopy to evaluate anastomoses can be done safely even in the early post-operative period. (2) The BAR anastomoses had the most serosal hematomas; BAR and sutured had more adhesions than stapled anastomoses; and sutured anastomoses had the most stenosis and fibrosis. None of these differences was of clinical significance. [ABSTRACT FROM AUTHOR] |
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| قاعدة البيانات: |
Complementary Index |
