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Bowel anastomoses: The theory, the practice and the evidence base

World Journal of Gastrointestinal Surgery 2012年第9期4卷 208-213页

作者： Frances Goulder Department of Colorectal Surgery University Hospital Lewisham Lewisham High Street London SE13 6LH United Kingdom

Since the introduction of stapling instruments in the 1970s various studies have compared the results of sutured and stapled bowel anastomoses. A literature search was performed from 1960 to 2010 and articles relating to small bowel, colonic and colorectal anastomotic techniques were reviewed. References from these articles were also reviewed, and relevant articles obtained. Either a stapled or sutured gastrointestinal tract anastomosis is acceptable in most situations. The available evidence suggests that in the following situations, however, particular anastomotic techniques may result in fewer complications: A stapled side-to-side ileocolic anastomosis is preferable following a right hemicolectomy for cancer. A stapled side-to-side anastomosis is likely also preferable after an ileocolic resection for Crohn’s disease. Colorectal anastomoses can be sutured or stapled with similar results, although the incidence of strictures is higher following stapled anastomoses. Following reversal of loop ileostomy there is some evidence to suggest that a stapled side-to-side anastomosis or sutured enterotomy closure (rather than spout resection and sutured anastomosis) results in fewer complications. Non-randomised data has indicated that small bowel anastomoses are best sutured in the trauma patient. This article reviews the theory, practice and evidence base behind the various gastrointestinal anastomoses to help the practising general surgeon make evidence based operative decisions.

关键词： Bowel Gastrointestinal Stapled Anastomosis anastomoses

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Clinical diagnostic advances in intestinal anastomotic techniques:Hand suturing,stapling,and compression devices

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World Journal of Gastrointestinal Surgery 2024年第5期16卷 1231-1234页

作者： Ah Young Lee Joo Young Cho Division of Gastroenterology Department of Internal MedicineCha Gangnam Medical CenterCha University College of MedicineSeoul 06135South Korea

The development of intestinal anastomosis techniques,including hand suturing,stapling,and compression anastomoses,has been a significant advancement in surgical *** methods aim to prevent leakage and minimize tissue fibrosis,which can lead to stricture *** healing process involves various phases:hemostasis and inflammation,proliferation,and *** staplers and sutures can cause inflammation and fibrosis due to the release of profibrotic *** anastomosis devices,including those made of nickel-titanium alloy,offer a minimally invasive option for various surgical challenges and have shown safety and ***,despite advancements,anastomotic techniques are evaluated based on leakage risk,with complications being a primary *** devices like Magnamosis use magnetic rings for compression anastomosis,demonstrating greater strength and patency compared to *** technology is also being explored for other medical *** there are promising results,particularly in animal models,the realworld application in humans is limited,and further research is needed to assess their safety and practicality.

关键词： anastomoses Diagnostic advances,Anastomotic techniques Technique Intestine

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Surgical Coronary Revascularization Using an Off-Pump, No-Touch Technique: The Cyclone (Hexalon) Experience

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Open Journal of Thoracic Surgery 2014年第4期4卷 94-99页

作者： Jeffrey M. Schussler Theodore T. Theologes Baron L. Hamman Division of Cardiology Baylor University Medical Center Dallas TX USA Texas A & M College of Medicine Dallas TX USA Division of Cardiothoracic Surgery Baylor University Medical Center Dallas TX USA

The CycloneTM System (Castlewood Surgical, Inc., Concord, MA) is a novel device that facilitates the attachment of the saphenous vein onto the ascending aorta for the purpose of creating a bypass graft during a coronary artery bypass grafting (CABG) operation. It allows the surgeon to perform a hand-sewn anastomosis with no disruption of the intima of the aorta, and no need for partial clamping. During a 36-month period 109 CABG operations were performed, and the CycloneTM System (and its predecessor, the HexalonTM) was utilized to create 138 proximal anastomoses. This study demonstrates that this is a safe and effective method of creating a clampless, no-touch proximal anastomoses during off-pump CABG.

关键词： No Touch Clampless Coronary Bypass CABG anastomoses Stroke

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