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16. Advocatus diaboli-Kommentar

Commentary of the Advocatus Diaboli

  • B. Wissenschaftliches Programm
  • I. Hauptthemen B. Europäisches Thema: Manuelle Naht versus/sive Maschinennaht
  • Published:
Langenbecks Archiv für Chirurgie Aims and scope Submit manuscript

Summary

The decision between hand suture or stapler was tested for the large bowel in randomized trials whereas retrospectively only in the upper gastrointestinal and respiratory tract. No clear difference was seen concerning patient's security and cost-time consumption. The stapler is more comfortable but the handsuture technique is still recommended. By the stapler anatomically very difficult anastomoses can be performed. Whether this is an advantage for the patient has to be tested because the technical progress may decrease physical function (incontinence!) and quality of life. In summary, the stapler, if applied critically, seems to be useful.

Zusammenfassung

Die Frage Hand- oder Maschinennaht wurde am Dickdarm in randomisierten Studien geprüft, dagegen nur retrospektiv am oberen GI-Trakt und der Lunge. Keine wesentlichen Unterschiede ergaben sich bei der Sicherheit des Patienten und der Zeitersparnis. Der Stapler ist komfortabler. Die Handnaht muss jedoch sicher beherrscht werden. Der Stapler erlaubt die Anlage anatomisch sehr schwieriger Anastomosen. Der Vorteil dieser Indikationserweiterung für den Patienten ist daran zu prüfen, ob das technisch Machbare zu Verlusten von Funktion (Inkontinenz) und Lebensqualität führt. Insgesamt erscheint die kritisch angewendete Maschinennaht vorteilhaft.

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Literatur

  1. Bearmann JE, Loewenson RB, Gullen WH (1974) Munch's postulates, laws and corollaries. Biometrics Note 4, National Eye Institute Bethesda, Maryland, US National Institute of Health

    Google Scholar 

  2. Beart Jr RW, Kelly KA (1981) Randomized prospective evaluation of the EEA stapler for colorectal anastomoses. Am J Surg 141:143–147

    Google Scholar 

  3. Bittner R, Butters M, Roscher R, Beger HG (1987) Oesophago-Jejunostomie - Wie sicher ist die Handnaht heute? Chirurg 58:43–45

    Google Scholar 

  4. Brennan ss, Pickford IR, Evans M, Pollock AV (1982) Staples or sutures for colonic anastomoses - a controlled clinical trial. Br J Surg 69:722–724

    Google Scholar 

  5. Everett WG, Friend PJ, Forty PJ (1986) Comparison of stapling and handsuture for left-sided large bowel anastomosis. Br J Surg 73:345–348

    Google Scholar 

  6. Fasth S (1987) Persönliche Mitteilung

  7. Forrester-Wood CP (1980) Bronchopleural fistula following pneumonectomy for carcinoma of the bronchus. J Thorac Cardiovasc Surg 80:406–409

    Google Scholar 

  8. Gamondes JP, Devolfe Ch, Girard C, Ducerf Ch, El Kirat AM (1983) Sutures mécanique et manuelle des moignons bronchiques dans la pneumonectomie droite. Etude comparative chez 64 opérés. Ann Chir Thorac Cardiovasc 37:130–132

    Google Scholar 

  9. Goligher JC (1982) Current trend in the use of sphincter saving excision in the treatment of carcinoma of the rectum. Cancer 50:2627–2630

    Google Scholar 

  10. Huttunen R, Laitinen S, Stählberg M, Mokka REM, Kairaluoma M, Larmi TKI (1982) Experiences with the EEA stapling instrument for anastomoses of the upper gastrointestinal tract. Acta Chir Scand 148:179–183

    Google Scholar 

  11. Jostarndt L, Thiede A, Lau G, Hamelmann H (1984) Die anorectale Kontinenz nach manueller und maschineller Anastomosennaht. Chirurg 55:385–390

    Google Scholar 

  12. Junginger Th, Walgenbach S, Pichlmaier H (1983) Die zirkuldre Klammeranastomose (EEA) nach Gastrektomie. Chirurg 54:161–165

    Google Scholar 

  13. Luke M, Kirkegaard P, Lendorf A, Christiansen J (1983) Pelvic recurrence rate after abdominoperineal resection and low anterior resection for rectal cancer before and after introduction of the stapling technique. World J Surg 7:616–619

    Google Scholar 

  14. McGinn FP (1985) Staples or sutures for low colorectal anastomoses: a prospective randomized trial. Br J Surg 72:603–605

    Google Scholar 

  15. Mennigen R, Kusche J, Leisten L, Erpenbach K (1987) Diamine oxidase (DAO) activity and intestinal mucosa integrity influence of suture techniques. Agents Actions 20:277–280

    Google Scholar 

  16. Metzger U, Weber W, Weber E, Linggi J, Buchmann P, Largiadèr F (1985) Lokalrezidive nach anteriore Rectumresection - Handnaht versus Klammernaht. Chirurg 56:266–268

    Google Scholar 

  17. Peterffy A, Calabrese E (1979) Mechanical and conventional manual sutures of the bronchial stump. Scand J Thorac Cardiovasc Surg 13:87–91

    Google Scholar 

  18. Polglase AL, Hughes ESR, McDermott FT, Burke FR (1981) A comparison of end-to-end staple and suture colorectal anastomosis in the dog. Surg Gynecol Obstet 152:792–796

    Google Scholar 

  19. Reiling RB, Reiling Jr WA, Bernie WA, Huffer AB, Perkins NC, Elliott DW (1980) Prospective controlled study of gastrointestinal stapled anastomoses. Am J Surg 139:147–151

    Google Scholar 

  20. Rosen CB, Beart RW, Ilstrup DM (1985) Local recurrence of rectal carcinoma after hand-sewn and stapled anastomoses. Dis Colon Rectum 28:305–309

    Google Scholar 

  21. Rubio CA, Nylander G, Wallin B, Sveander M, Alun ML, Duvander A (1984) Carcinogenesis at colonic anastomosic sites. An animal study. Dis Colon Rectum 27:468–470

    Google Scholar 

  22. Scott RN, Faraci RP, Hough A, Chretien PB (1976) Bronchial stump closure techniques following pneumonectomy: a serial comparative study. Ann Surg 184:205–211

    Google Scholar 

  23. Templeton JL, McKelvey STD (1985) Low colorectal anastomoses. An experimental assessment of two sutured and two stapled techniques. Dis Colon Rectum 28:38–41

    Google Scholar 

  24. Thiede A, Schubert G, Poser HL, Jostarndt L (1984) Zur Technik der Rectumanastomosen bei Rectumresektionen. Chirurg 55:326–335

    Google Scholar 

  25. Thiede A, Fuchs KH, Hamelmann H (1985) Rouch und Roux-Y-Rekonstruktion nach Gastrektomie. Chirurg 56:599–604

    Google Scholar 

  26. Troidl H, Spitzer WO, McPeek B, Mulder DS, McKneally MF (1986) Principles and practice of research. Strategies for surgical investigators. Springer, Berlin Heidelberg New York

    Google Scholar 

  27. Troidl H, Kusche J, Bouillon B, Eypasch E (1987) Quality of life: An important point in daily surgical practice. J Chron Dis (im Druck)

  28. Troidl H, Kusche J, Vestweber KH, Eypasch E, Maul U (1987) Pouch versus esophago-jejunostomy after total gastrectomy: A randomized clinical trial. (im Druck)

  29. Walther BS, Strand SE, Oscarson J, Löwenhielm P, Stählberg F, Evander A, Uvelius B (1986) Healing of esophagojejunal anastomoses after experimental total gastrectomy. A comparative study using manually sutured or stapled anastomoses. Ann Surg 203:439–446

    Google Scholar 

  30. West PhN, Marbarger JP, Martz MN, Roper ChL (1981) Esophagogastrostomy with the EEA stapler. Ann Surg 194:76–81

    Google Scholar 

  31. Williams NS, Johnston D (1984) Survival and recurrence after sphincter saving resection and abdominoperineal resection for carcinoma of the middle third of the rectum. Br J Surg 71:278–282

    Google Scholar 

  32. Wolmark N, Gordon PH, Fisher B, Weinand S, Lemer H, Lawrence W, Shibata H (1986) A comparison of stapled and handsewn anastomoses in patients undergoing resection for Duke's B and C colorectal cancer. Dis Colon Rectum 29:344–351

    Google Scholar 

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Authors and Affiliations

  1. II. Lehrstuhl für Chirurgie der Universität zu Köln, Ostmerheimer Strasse 200, D-5000, Köln 91

    H. Troidl, S. Büechl, J. Kusche & P. Gauda

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  1. H. Troidl
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  2. S. Büechl
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  3. J. Kusche
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  4. P. Gauda
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Troidl, H., Büechl, S., Kusche, J. et al. 16. Advocatus diaboli-Kommentar. Langenbecks Arch Chiv 372, 113–120 (1987). https://doi.org/10.1007/BF01297800

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  • DOI: https://doi.org/10.1007/BF01297800

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