[Use of surgical staplers in emergency surgery].
OBJECTIVE
Over the past decade the use of surgical staplers has resulted in a substantial change in both elective and emergency surgery for gastrointestinal pathologies. A large number of studies have now affirmed the safety, reliability, simplicity, rapidity and usefulness of these instruments. They offer many advantages, above all the possibility of shortening operating times and thus reducing morbidity and mortality, especially in emergency surgery.


METHODS
The authors describe their experience in treating 68 cases of emergency intestinal resection from 1980 to 1997 which were treated with the help of automatic staplers. Twenty-three cases of hemicolectomy (right and left) were performed; 17 sigmoid resections for diverticulitis; 15 gastric sections using Billroth II; 7 Meckel's diverticuli; 6 total gastrectomies. GEA 50 and 75 staplers were used for the intestine, TA 50, 90, 90 Plus and Roticulator, Circular staplers for esophagus, stomach and rectum. Patients were predominantly male: 40 males and 25 females with a ratio of 2:1.


RESULTS
Complications included a fistula caused by dehiscence of the esophagojejunal anastomosis which lead to death in 30 days; 3 cases of hemorrhage of the gastroenteric anastomosis which regressed with medical therapy.


CONCLUSIONS
In conclusion, mechanical staplers have led to considerable savings in time and a reduced number of postoperative complications.
Vadalà
G
G
Cattedra di Chirurgia d'Urgenza e Pronto Soccorso, Università degli Studi, Catania.
Caragliano
L
L
Bordonaro
A
A
Castorina
R
R
Caragliano
P
P
D000328:Adult; D000368:Aged; D003082:Colectomy; D013505:Digestive System Surgical Procedures / Q000295:instrumentation*; D004238:Diverticulitis / Q000601:surgery; D004378:Duodenal Diseases / Q000209:etiology; D004630:Emergencies; D004937:Esophageal Fistula / Q000209:etiology; D005260:Female; D005743:Gastrectomy; D005763:Gastroenterostomy; D006470:Hemorrhage / Q000209:etiology; D006801:Humans; D007412:Intestinal Fistula / Q000209:etiology; D008297:Male; D008467:Meckel Diverticulum / Q000601:surgery; D008875:Middle Aged; D012189:Retrospective Studies; D012810:Sigmoid Diseases / Q000601:surgery; D013529:Surgical Wound Dehiscence / Q000209:etiology; D013537:Sutures / Q000009:adverse effects; D016896:Treatment Outcome
L'utilizzo delle suturatrici meccaniche in chirurgia d'urgenza.