{"title":"腹腔镜结肠切除术中肠切开术吻合术与手缝缝合术的对比：体外研究。","authors":"Tetsuo Ishizaki, Junichi Mazaki, Kenta Kasahara, Ryutaro Udo, Tomoya Tago, Yuichi Nagakawa","doi":"10.1007/s10151-025-03190-8","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>In laparoscopic colectomy, overlap anastomosis (OA) is the most standard method of intracorporeal anastomosis. To avoid narrowing the anastomotic area, the closure of the enterotomy is often performed with handsewn running sutures of the monofilament. The purpose of this study was to compare two porcine in vitro colon models of stapled versus handsewn closure of enterotomy in intracorporeal OA.</p><p><strong>Methods: </strong>In total, 40 porcine in vitro colon OA models (20 cases in the stapled closure, SC group, in which the enterotomy was closed with a stapler, and 20 cases in the handsewn closure with monofilament, HC group) were created, and anastomotic area with maximum intensity projection-computed tomography, anastomotic time, and leakage pressure were measured.</p><p><strong>Results: </strong>In the anastomotic area, there was no significant difference between in the SC group and HC group (474.0 ± 105.0 mm<sup>2</sup> versus 502.6 ± 155.6 mm<sup>2</sup>, p = 0.552). The anastomotic time was significantly shorter in the SC group than in the HC group (185.9 ± 38.3 s versus 292.4 ± 67.8 s, p < 0.001). The leakage pressure was significantly higher in the SC group than in the HC group (30.1 ± 3.8 mmHg versus 21.6 ± 5.3 mmHg, p < 0.001).</p><p><strong>Conclusions: </strong>The findings of this study using porcine in vitro colon model showed that, in OA, the anastomotic area was similar, anastomotic time was significantly shorter, and leakage pressure was significantly higher in SC compared with HC. The results suggest that SC may be superior to HC when performing intracorporeal OA in laparoscopic surgery for colon cancer.</p>","PeriodicalId":51192,"journal":{"name":"Techniques in Coloproctology","volume":"29 1","pages":"148"},"PeriodicalIF":2.9000,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Stapled versus handsewn closure of enterotomy for intracorporeal overlap anastomosis in laparoscopic colectomy: in vitro study.\",\"authors\":\"Tetsuo Ishizaki, Junichi Mazaki, Kenta Kasahara, Ryutaro Udo, Tomoya Tago, Yuichi Nagakawa\",\"doi\":\"10.1007/s10151-025-03190-8\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>In laparoscopic colectomy, overlap anastomosis (OA) is the most standard method of intracorporeal anastomosis. To avoid narrowing the anastomotic area, the closure of the enterotomy is often performed with handsewn running sutures of the monofilament. The purpose of this study was to compare two porcine in vitro colon models of stapled versus handsewn closure of enterotomy in intracorporeal OA.</p><p><strong>Methods: </strong>In total, 40 porcine in vitro colon OA models (20 cases in the stapled closure, SC group, in which the enterotomy was closed with a stapler, and 20 cases in the handsewn closure with monofilament, HC group) were created, and anastomotic area with maximum intensity projection-computed tomography, anastomotic time, and leakage pressure were measured.</p><p><strong>Results: </strong>In the anastomotic area, there was no significant difference between in the SC group and HC group (474.0 ± 105.0 mm<sup>2</sup> versus 502.6 ± 155.6 mm<sup>2</sup>, p = 0.552). The anastomotic time was significantly shorter in the SC group than in the HC group (185.9 ± 38.3 s versus 292.4 ± 67.8 s, p < 0.001). The leakage pressure was significantly higher in the SC group than in the HC group (30.1 ± 3.8 mmHg versus 21.6 ± 5.3 mmHg, p < 0.001).</p><p><strong>Conclusions: </strong>The findings of this study using porcine in vitro colon model showed that, in OA, the anastomotic area was similar, anastomotic time was significantly shorter, and leakage pressure was significantly higher in SC compared with HC. The results suggest that SC may be superior to HC when performing intracorporeal OA in laparoscopic surgery for colon cancer.</p>\",\"PeriodicalId\":51192,\"journal\":{\"name\":\"Techniques in Coloproctology\",\"volume\":\"29 1\",\"pages\":\"148\"},\"PeriodicalIF\":2.9000,\"publicationDate\":\"2025-07-22\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Techniques in Coloproctology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1007/s10151-025-03190-8\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"GASTROENTEROLOGY & HEPATOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Techniques in Coloproctology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s10151-025-03190-8","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"GASTROENTEROLOGY & HEPATOLOGY","Score":null,"Total":0}
引用次数: 0
摘要
背景：在腹腔镜结肠切除术中，重叠吻合（OA）是最标准的体内吻合方法。为避免吻合区狭窄，肠切开术的闭合通常采用单丝手工缝合。本研究的目的是比较两种猪体外结肠模型，即在体内OA中缝合和手工缝合小肠。方法：共制作猪体外结肠OA模型40例（吻合器闭合组20例，SC组，吻合器闭合；单丝手工缝合组，HC组，20例），测量吻合口最大强度投影-计算机断层扫描面积、吻合时间、漏压。结果：SC组与HC组吻合口面积差异无统计学意义（474.0±105.0 mm2 vs 502.6±155.6 mm2, p = 0.552）。SC组吻合时间明显短于HC组（185.9±38.3 s vs 292.4±67.8 s） p结论：本研究采用猪离体结肠模型，OA组吻合面积相似，吻合时间明显短于HC组，漏压明显高于HC组。结果表明，在腹腔镜结肠癌手术中，SC可能优于HC。
Stapled versus handsewn closure of enterotomy for intracorporeal overlap anastomosis in laparoscopic colectomy: in vitro study.
Background: In laparoscopic colectomy, overlap anastomosis (OA) is the most standard method of intracorporeal anastomosis. To avoid narrowing the anastomotic area, the closure of the enterotomy is often performed with handsewn running sutures of the monofilament. The purpose of this study was to compare two porcine in vitro colon models of stapled versus handsewn closure of enterotomy in intracorporeal OA.
Methods: In total, 40 porcine in vitro colon OA models (20 cases in the stapled closure, SC group, in which the enterotomy was closed with a stapler, and 20 cases in the handsewn closure with monofilament, HC group) were created, and anastomotic area with maximum intensity projection-computed tomography, anastomotic time, and leakage pressure were measured.
Results: In the anastomotic area, there was no significant difference between in the SC group and HC group (474.0 ± 105.0 mm2 versus 502.6 ± 155.6 mm2, p = 0.552). The anastomotic time was significantly shorter in the SC group than in the HC group (185.9 ± 38.3 s versus 292.4 ± 67.8 s, p < 0.001). The leakage pressure was significantly higher in the SC group than in the HC group (30.1 ± 3.8 mmHg versus 21.6 ± 5.3 mmHg, p < 0.001).
Conclusions: The findings of this study using porcine in vitro colon model showed that, in OA, the anastomotic area was similar, anastomotic time was significantly shorter, and leakage pressure was significantly higher in SC compared with HC. The results suggest that SC may be superior to HC when performing intracorporeal OA in laparoscopic surgery for colon cancer.
期刊介绍：
Techniques in Coloproctology is an international journal fully devoted to diagnostic and operative procedures carried out in the management of colorectal diseases. Imaging, clinical physiology, laparoscopy, open abdominal surgery and proctoperineology are the main topics covered by the journal. Reviews, original articles, technical notes and short communications with many detailed illustrations render this publication indispensable for coloproctologists and related specialists. Both surgeons and gastroenterologists are represented on the distinguished Editorial Board, together with pathologists, radiologists and basic scientists from all over the world. The journal is strongly recommended to those who wish to be updated on recent developments in the field, and improve the standards of their work.
Manuscripts submitted for publication must contain a statement to the effect that all human studies have been reviewed by the appropriate ethics committee and have therefore been performed in accordance with the ethical standards laid down in an appropriate version of the 1965 Declaration of Helsinki. It should also be stated clearly in the text that all persons gave their informed consent prior to their inclusion in the study. Details that might disclose the identity of the subjects under study should be omitted. Reports of animal experiments must state that the Principles of Laboratory Animal Care (NIH publication no. 86-23 revised 1985) were followed as were applicable national laws (e.g. the current version of the German Law on the Protection of Animals). The Editor-in-Chief reserves the right to reject manuscripts that do not comply with the above-mentioned requirements. Authors will be held responsible for false statements or for failure to fulfill such requirements.
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