Intestinale Anastomosen und Techniken im Bereich des unteren Gastrointestinaltraktes

Mohr, Z.; Willis, S.

doi:10.1007/s00104-010-1901-y

Cited by 3 publications

(7 citation statements)

References 33 publications

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“…Absorbable or non absorbable suture materials can be used. 4 , 6 , 16 , 17 Generally, the design of the hand seam is determined by the number of rows, the layering, the suturing technique and the adaptation technique. 6 , 18 , 19 There is a lack of significant research (prospective/randomized trials) comparing and evaluating the surgical outcomes of the various hand-suturing parameters, so no clear superiority of one of the diverse influencing variables could be determined so far.…”

Section: Resultsmentioning

confidence: 99%

“… 4 , 6 , 16 , 17 Generally, the design of the hand seam is determined by the number of rows, the layering, the suturing technique and the adaptation technique. 6 , 18 , 19 There is a lack of significant research (prospective/randomized trials) comparing and evaluating the surgical outcomes of the various hand-suturing parameters, so no clear superiority of one of the diverse influencing variables could be determined so far. 20 Some groups established that there is no significant difference between single-layer or double-layer techniques concerning postoperative complications.…”

Section: Resultsmentioning

confidence: 99%

“…With the beginning of laparoscopy in the 1990s, stapling systems became increasingly important and quickly developed into the most commonly used anastomosis technique. 6 , 26 , 27 Releasing the applicator, the staples are inserted permanently into the tissue and thus connect the two segments after intestinal resection. 26 Depending on the shape of the system, various principles of stapling devices can be distinguished.…”

Section: Resultsmentioning

confidence: 99%

“…In order to objectively assess the individual anastomosis techniques regarding their suitability to allow for comprehensive trauma minimization for the patient, we first aimed at defining assessment criteria that were derived from expert discussions and literature. 6 , 8 , 9 , 12–16 Explicitly, we assumed the postoperative safety of patients to be the most important aspect in the evaluation of an anastomosis technique. Postoperative complications such as the incidence of leakages, mortality rates, bleeding, abscesses, etc are subsumed under this parameter, which was investigated in our meta-analysis.…”

Section: Methodsmentioning

confidence: 99%

“…Various techniques to create intestinal anastomoses have evolved, such as hand-suturing, stapling and compression anastomoses, 4 , 6 but the question arises whether any fully meet our clinical demands, not only today but also with respect to the future. With the development of new techniques and disciplines, such as interventional endoscopy, colonic surgery is also subject to rapid changes that involve an ever increasing reduction of surgical trauma to enhance patient treatment standards.…”

Section: Introductionmentioning

confidence: 99%

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Systematic Review and Meta-Analysis on Colorectal Anastomotic Techniques

Steger¹,

Jell²,

Ficht³

et al. 2022

TCRM

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Purpose Anastomosis creation after resective gastrointestinal surgery is a crucial task. The present review examines the techniques and implants currently available for anastomosis creation and analyses to which extent they already address our clinical needs, with a special focus on their potential to enable further trauma minimization in visceral surgery. Methods A multi-database research was conducted in MEDLINE, Scopus, and Cochrane Library. Comparative controlled and uncontrolled clinical trials dealing with anastomosis creation techniques in the intestinal tract in both German and English were included and statistically significant differences in postoperative complication incidences were assessed using the RevMan5.4 Review Manager (Cochrane Collaboration, Oxford, UK). Results All methods and implant types were analyzed and compared with respect to four dimensions, assessing the techniques’ current performances and further potentials for surgical trauma reduction. Postoperative outcome measures, such as leakage, stenosis, reoperation and mortality rates, as well as the tendency to cause bleeding, wound infections, abscesses, anastomotic hemorrhages, pulmonary embolisms, and fistulas were assessed, revealing the only statistically significant superiority of hand-suture over stapling anastomoses with respect to the occurrence of obstructions. Conclusion Based on the overall complication rates, it is concluded that none of the anastomosis systems addresses the demands of operative trauma minimization sufficiently yet. Major problems are furthermore either low standardization potentials due to dependence on the surgeons’ levels of experience, high force application requirements for the actual anastomosis creation, or large and rigid device designs interfering with flexibility demands and size restrictions of the body’s natural access routes. There is still a need for innovative technologies, especially with regard to enabling incisionless interventions.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Systematic Review and Meta-Analysis on Colorectal Anastomotic Techniques

Steger¹,

Jell²,

Ficht³

et al. 2022

TCRM

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Anastomosentechniken am GastrointestinaItrakt

Laukötter

Senninger

2013

Chirurg

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The correct suture technique for anastomoses of the gastrointestinal (GI) tract is a major task in the daily practice of surgery and a basic requirement for a successful operation. This article provides an overview of the surgical principles and techniques involved in the creation of intestinal anastomoses, including the differentiated use of various suturing aids in the GI tract. Hand sewn and stapled anastomotic techniques are illustrated and discussed. The ongoing discussion and question as to which technique is best for GI anastomoses remains unanswered as there is no obligatory standard, even though the requirements are well defined. An ideal anastomosis should fulfil the following criteria: it must be well vascularized, safe, tension-free and spillage from the operation field should be avoided.

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