{"title":"使用带动力吻合器系统的强化三排吻合器可减少远端胰腺切除术后胰瘘的发生。","authors":"Shinjiro Kobayashi, Keisuke Ida, Saori Umezawa, Kazunari Nakahara, Keisuke Tateishi, Tomoko Norose, Nobuyuki Ohike, Tsuyoshi Morimoto, Shinya Mikami, Takehito Otsubo","doi":"10.1007/s00595-025-03123-w","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>Stapled closure is the standard technique for pancreatic resection via distal pancreatectomy (DP). The Signia™ Stapling System allows for adaptive stapling based on real-time tissue resistance. This study aims to investigate whether DP using the Signia™ system could reduce the incidence of clinically relevant post-operative pancreatic fistula (CR-POPF).</p><p><strong>Methods: </strong>We retrospectively analyzed 53 patients who underwent DP between 2020 and 2025. 26 patients underwent DP using the Signia™ Stapling System (powered stapler group), and 27 patients using a manual stapler (manual stapler group). The primary outcome was the CR-POPF rate.</p><p><strong>Results: </strong>In the powered stapler group, 38.5% of patients developed biochemical leakage, but no cases of CR-POPF were observed. In contrast, the manual stapler group had a CR-POPF rate of 18.5% (p = 0.021). A receiver operating characteristic curve was generated to determine the pancreatic thickness threshold predictive of CR-POPF. The calculated cut-off value was 16 mm. In the powered group, there were no cases of CR-POPF even if the pancreatic thickness at the resection line was ≥ 16 mm.</p><p><strong>Conclusions: </strong>The use of a powered stapler may therefore help reduce the risk of POPF associated with variability in the thickness and hardness of the pancreas during DP.</p>","PeriodicalId":22163,"journal":{"name":"Surgery Today","volume":" ","pages":""},"PeriodicalIF":1.6000,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Use of a reinforced triple-row stapler with a powered stapling system reduces the occurrence of postoperative pancreatic fistula after distal pancreatectomy.\",\"authors\":\"Shinjiro Kobayashi, Keisuke Ida, Saori Umezawa, Kazunari Nakahara, Keisuke Tateishi, Tomoko Norose, Nobuyuki Ohike, Tsuyoshi Morimoto, Shinya Mikami, Takehito Otsubo\",\"doi\":\"10.1007/s00595-025-03123-w\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>Stapled closure is the standard technique for pancreatic resection via distal pancreatectomy (DP). The Signia™ Stapling System allows for adaptive stapling based on real-time tissue resistance. This study aims to investigate whether DP using the Signia™ system could reduce the incidence of clinically relevant post-operative pancreatic fistula (CR-POPF).</p><p><strong>Methods: </strong>We retrospectively analyzed 53 patients who underwent DP between 2020 and 2025. 26 patients underwent DP using the Signia™ Stapling System (powered stapler group), and 27 patients using a manual stapler (manual stapler group). The primary outcome was the CR-POPF rate.</p><p><strong>Results: </strong>In the powered stapler group, 38.5% of patients developed biochemical leakage, but no cases of CR-POPF were observed. In contrast, the manual stapler group had a CR-POPF rate of 18.5% (p = 0.021). A receiver operating characteristic curve was generated to determine the pancreatic thickness threshold predictive of CR-POPF. The calculated cut-off value was 16 mm. In the powered group, there were no cases of CR-POPF even if the pancreatic thickness at the resection line was ≥ 16 mm.</p><p><strong>Conclusions: </strong>The use of a powered stapler may therefore help reduce the risk of POPF associated with variability in the thickness and hardness of the pancreas during DP.</p>\",\"PeriodicalId\":22163,\"journal\":{\"name\":\"Surgery Today\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":1.6000,\"publicationDate\":\"2025-08-27\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Surgery Today\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1007/s00595-025-03123-w\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"SURGERY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Surgery Today","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s00595-025-03123-w","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"SURGERY","Score":null,"Total":0}
Use of a reinforced triple-row stapler with a powered stapling system reduces the occurrence of postoperative pancreatic fistula after distal pancreatectomy.
Purpose: Stapled closure is the standard technique for pancreatic resection via distal pancreatectomy (DP). The Signia™ Stapling System allows for adaptive stapling based on real-time tissue resistance. This study aims to investigate whether DP using the Signia™ system could reduce the incidence of clinically relevant post-operative pancreatic fistula (CR-POPF).
Methods: We retrospectively analyzed 53 patients who underwent DP between 2020 and 2025. 26 patients underwent DP using the Signia™ Stapling System (powered stapler group), and 27 patients using a manual stapler (manual stapler group). The primary outcome was the CR-POPF rate.
Results: In the powered stapler group, 38.5% of patients developed biochemical leakage, but no cases of CR-POPF were observed. In contrast, the manual stapler group had a CR-POPF rate of 18.5% (p = 0.021). A receiver operating characteristic curve was generated to determine the pancreatic thickness threshold predictive of CR-POPF. The calculated cut-off value was 16 mm. In the powered group, there were no cases of CR-POPF even if the pancreatic thickness at the resection line was ≥ 16 mm.
Conclusions: The use of a powered stapler may therefore help reduce the risk of POPF associated with variability in the thickness and hardness of the pancreas during DP.
期刊介绍：
Surgery Today is the official journal of the Japan Surgical Society. The main purpose of the journal is to provide a place for the publication of high-quality papers documenting recent advances and new developments in all fields of surgery, both clinical and experimental. The journal welcomes original papers, review articles, and short communications, as well as short technical reports("How to do it").
The "How to do it" section will includes short articles on methods or techniques recommended for practical surgery. Papers submitted to the journal are reviewed by an international editorial board. Field of interest: All fields of surgery.
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