In:
Digestive Surgery, S. Karger AG, Vol. 39, No. 5-6 ( 2022), p. 232-241
Kurzfassung:
〈 b 〉 〈 i 〉 Introduction: 〈 /i 〉 〈 /b 〉 Despite progressive improvements in technical skills and instruments that have facilitated surgeons performing intracorporeal gastro-jejunal and jejuno-jejunal anastomoses, one of the big challenging tasks is handsewn knot tying. We analysed the better way to fashion a handsewn intracorporeal enterotomy closure after a stapled anastomosis. 〈 b 〉 〈 i 〉 Methods: 〈 /i 〉 〈 /b 〉 All 579 consecutive patients from January 2009 to December 2019 who underwent minimally invasive partial gastrectomy for gastric cancer were retrospectively analysed. Different ways to fashion intracorporeal anastomoses were investigated: robotic versus laparoscopic approach; laparoscopic high definition versus three-dimensional versus 4K technology; single-layer versus double-layer enterotomies. Double-layer enterotomies were analysed layer by layer, comparing running versus interrupted suture; the presence versus absence of deep corner suture; and type of suture thread. 〈 b 〉 〈 i 〉 Results: 〈 /i 〉 〈 /b 〉 Significantly lower rates of bleeding ( 〈 i 〉 p 〈 /i 〉 = 0.011) and leakage ( 〈 i 〉 p 〈 /i 〉 = 0.048) from gastro-jejunal anastomosis were recorded in the double-layer group. Barbed suture thread was significantly associated with reduced intraluminal bleeding and leakage rates both in the first ( 〈 i 〉 p 〈 /i 〉 = 0.042 and 〈 i 〉 p 〈 /i 〉 = 0.010) and second layer ( 〈 i 〉 p 〈 /i 〉 = 0.002 and 〈 i 〉 p 〈 /i 〉 = 0.029). 〈 b 〉 〈 i 〉 Conclusions: 〈 /i 〉 〈 /b 〉 Double-layer sutures using barbed suture thread both in first and second layer to fashion enterotomy closure result in lower intraluminal bleeding and anastomotic leak rates.
Materialart:
Online-Ressource
ISSN:
0253-4886
,
1421-9883
Sprache:
Englisch
Verlag:
S. Karger AG
Publikationsdatum:
2022
ZDB Id:
1468560-7