腹腔鏡補助下大腸切除術における腸管再建 : linear cutterを使用した三角吻合

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During laparoscopic colectomy, we usually perform a triangulating end-to-end intestinal anastomosis using a linear cutter three times in order to complete a safe reconstructive operation within a short time through a small wound in the abdomen. We herein report the surgical technique and results of the operation. The present study examined 34 patients who underwent a triangulating anastomosis during laparoscopically assisted colectomy. Controls were 18 patients in whom the intestinal anastomosis was performed using Gambee's hand-sawn method during a similar time period. The mean age was 68.9±7.6 years for the patients who had the triangulating anastomosis and 60.2±9.3 years for those who had the anastomosis using Gambee's technique ; hence the triangulating anastomosis procedure was chosen for older patients. The time required to complete the triangulating anastomosis and Gambee's method were 14.6±2.9 and 29.7±3.3 min, respectively ; the former was completed within about half the length of time of that required for the latter. No complications such as anastomotic leakage or stenosis at the site of anastomosis occurred in either group. Bleeding at the anastomosed site was noted in a patient who had the triangulating anastomosis, but it subsided following a conservative therapy. Here described is the triangulating anastomosis for intestinal reconstruction using a linear cutter three times during laparoscopic colectomy. This method is proven to have many advantages including the simplicity and safety of the operational procedure as well as a short operative duration. It is thus suitable to perform intestinal anastomosis through a small wound in the abdomen, and it will be widely used in the future.
東京女子医科大学の論文

腹腔鏡補助下大腸切除術における腸管再建 : linear cutterを使用した三角吻合

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