Cabrera JP, Caselli BE, Pérez N, Lynch O, Kawaguchi F, Madariaga J

Language: Spanish
References: 18
Page: 80-84
PDF size: 81.11 Kb.

ABSTRACT

Introduction: The anastomosis of colon surgery can be made by means of manual suture or mechanic suture. In the last time, the mechanic suture has been developed, because is a standarized method, transmissible and fast in its execution; however, has high cost. The objective is evaluate the cost and efectivity of the manual suture to anastomosis for colonic cancer. Material and methods: 70 patients with colonic cancer, 33 men (47%) and 37 women (53%), average age 60.34 years old (range 26-84). This patients were operate consecutively between June 1986 and May 2006 at the Pensioned Service of the Hospital Clinico Regional de Concepcion. There was 62 hemicolectomies, 5 by-pass, 2 reconstruction of colonic transit after Hartmann and 1 total colectomy. In this surgeries, there was 38 latero-laterals anastomosis, 29 termino-terminals anastomosis and 3 latero-terminals anastomosis. Technic and material used: total stitch facing mucous to mucous. Vicryl® absorbible matherial, one suture in posterior plan and two on anterior plan. We used student-t to the continues variables and consider statisticment significant p‹0.05. Results: It has 11 postoperative complications (16%): 6 medics and 5 surgicals. There was not hemorrhage, dehiscence and stenosis on the anastomosis. There was not operative mortality. Average operative hospital stay was 11.6 días (DS=3.39), according to sex it was NS and according to age, if =60 years old v/s ›60 years old NS. Conclusions: The suture technic that we describe it is safe and low cost for the colonic cancer anastomosis. Should be considered as a efficient and effective alternative in colonic cancer surgeries.

REFERENCES

1. Fazio V, Lopez-Kostner F. Role of laparoscopic surgery for treatment of early colorectal carcinoma. World J Surg 2000; 24(9): 1056-60.

2. Lacy A, Garcia-Valdecasas J, Delgado S. Laparoscopy-assisted colectomy versus open colectomy for treatment of non-metastatic colon cancer: a randomised trial. Lancet 2002; 359(9325): 2224-9.

3. Soto G. Anastomosis manual en cirugía laparoscópica de colon. Un modelo experimental factible. Rev Chil Cir 2005; 57 (2): 149-154.

4. Bannura G. Factores predictivos de estenosis de la anastomosis colorrectal mecánica: análisis prospectivo de 179 pacientes. Rev Chil Cir 2004; 56 (2): 125-131.

5. Carty N, Keating J, Campbell J. Prospective audit of an extramucosal technique for intestinal anastomosis. Br J Surg 1991; 78: 1439-41.

6. Macdonald J. Influence of the distance between interrupted sutures and the tension of sutures on the healing of experimental colonic anastomoses. Am J Surg, 1992; 163: 319-23.

7. Wexner S, Moscovitz I. Laparoscopic colectomy in diverticular and Crohn's disease. Surg Clin North Am 2000; 80(4): 1299-319.

8. Gullichsen R, Havia T, Ovaska J, and Rantala A. Colonic anastomosis using the biofragmentable anastomotic ring and manual suture: a prospective, randomized study. Br J Surg 1992; 79: 578-80.

9. López F, Soto G, Zárate A. Protocolo de cirugía laparoscópica intestinal. Rev Chil Cir 2003; 55: 225-231.

10. Choi H, Kim H, Jung G, Kim S. Intestinal anastomosis by use of the biofragmentable anastomotic ring: is it safe and efficacious in emergency operations as well? Dis Colon Rectum 1998; 41: 1281-6.

11. Gullichsen R, Ovaska J, Rantala A, Havia T. Small bowel anastomosis with the biofragmentable anastomosis ring and manual suture: a prospective, randomized study. World J Surg 1992; 16: 1006-9.

12. Dwivedi A, Chahin F, Agrawal S. Laparoscopic colectomy vs open colectomy for sigmoid diverticular disease. Dis Colon Rectum 2002; 45(10): 1309-15.

13. Franklin M, Rosenthal D, Abrego-Medina D. Prospective comparison of open vs. laparoscopic colon surgery for carcinoma. Five-year results. Dis Colon Rectum 1996; 39(10 Suppl): S35-46.

14. Tang C, Eu K, Tai B. Randomized clinical trial of the effect of open versus laparoscopically assisted colectomy on systemic immunity in patients with colorectal cancer. Br J Surg 2001; 88(6): 801-7.

15. Kim S, Choi H, Park K. Sutureless intestinal anastomosis with the biofragmentable anastomosis ring: experience of 632 anastomoses in a single institute. Jung Dis Colon Rectum 2005; 48: 2127-32.

16. Hermansen T, Rodríguez E, Salamanca J. Reconstitución de tránsito después de la operación de Hartmann con videolaparoscopía asistida. Rev Chil Cir 1998; 50(6): 633-6.

17. MacRae H, McLeod R. Handsewn vs stapled anastomoses in colon and rectal surgery: a meta-analysis. Dis Colon Rectum 1998; 41(2): 180-9.

18. Sánchez-Medina R. Anastomosis manual versus anastomosis mecánica en cirugía colorrectal. Cir Ciruj 2003; 71(1): 39-44.