Intraoperative Colonoscopy for Stapled Anastomosis in Colorectal Surgery
Intraoperative Colonoscopy for Stapled Anastomosis in Colorectal Surgery
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DOI：
10.1007/s00595-007-3740-0
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发表时间：
2008-11-01
期刊：
影响因子：
2.5
通讯作者：
Nagawa, Hirokazu
中科院分区：
文献类型：
--
作者：
Ishihara, Soichiro;Watanabe, Toshiaki;Nagawa, Hirokazu
尽管吻合器结直肠吻合术被广泛接受为手动缝合吻合术的替代方法，但我们仍会遇到吻合口出血和吻合口漏等术后并发症，有时会导致严重的发病率甚至死亡率。为了确保结直肠吻合，我们采用了术中结肠镜检查（IOCS）。2004年11月至2005年10月，我们对73例结直肠切除术后吻合器吻合进行了IOCS。术中结肠镜检查显示7例患者（9.6%）吻合器吻合口活动性出血。其中，6例患者进行了额外缝合，另1例患者的吻合口外置。4例患者（5.5%）通过IOCS进行的漏气测试呈阳性，2例患者进行了额外缝合，另外2例患者进行了重新缝合。在一名患者中发现粘膜切割不完全，但成功地进行了处理。引入IOCS后，无术后吻合口出血病例，仅1例吻合口瘘（1.4%）。
Although stapling colorectal anastomosis is widely accepted as an alternative for hand-sewn anastomosis, we continue to experience postoperative complications such as anastomotic hemorrhage and leakage, which sometimes lead to serious morbidity or even mortality. To secure stapling colorectal anastomosis, we adopted intraoperative colonoscopy (IOCS). We performed IOCS in 73 cases of colorectal resection with stapling anastomosis from November 2004 to October 2005. Intraoperative colonoscopy revealed active bleeding from stapling anastomosis in 7 patients (9.6%). Of these, additional sutures were done in 6 patients, while the anastomosis was exteriorized in the other. The air leak test performed by IOCS was positive in 4 patients (5.5%), with additional sutures being done in 2 patients and reanastomoses performed in the other 2. Incomplete cutting of the mucosa was found in one patient, but it was successfully managed. Following the introduction of IOCS, there were no cases of postoperative anastomotic hemorrhage, and only one case of anastomotic leakage (1.4%).