[Technic of rectum anastomoses in rectum resection. A controlled study: instrumental suture versus hand suture].
Stapler and manual sutures in rectal end-to-end anastomoses were compared in a controlled trial. The following results were obtained: For the analysis the cases naturally separated into three groups, A (manual suture), B (planned stapler suture) and WD ("withdrawn" cases, from both groups, in which continence could be maintained only with a stapler suture). The distribution of the WD cases in dependence on localization and sex varied significantly from groups A and B, while A and B remained comparable, in spite of the WD cases. The analysis of the date showed no, or only slight, clinical differences. In a comparison of the two stapler groups B and WD, significantly more suture dehiscences, colocutaneous fistulae and post-operative disturbances in bladder function were found in group WD. As a general conclusion we can state that: In comparable anastomosis localizations it is possible to achieve almost the same clinical results with both suture techniques. With a circular stapler it is, however, technically possible to perform rectum resections in cases in which this was not previously possible, particularly in men with a narrow pelvis and a stale pelvic floor. To what extent this still is an advantage after the local recurrences are taken into consideration remains to be seen.
D002986:Clinical Trials as Topic; D006801:Humans; D011183:Postoperative Complications / Q000401:mortality; D012004:Rectal Neoplasms / Q000601:surgery*; D012007:Rectum / Q000601:surgery*; D013528:Surgical Staplers; D013536:Suture Techniques; D014945:Wound Healing
Zur Technik der Rectumanastomosen bei Rectumresektionen. Eine kontrollierte Studie: Instrumentelle Naht versus Handnaht.