In a series of 189 patients, 197 operations (251 stapled anastomoses) were performed. U.S. Surgical Corporation instruments (GIA n = 156, EEA n = 36, TA n = 59) were used in surgery of the stomach, pancreas, small and large bowel, and the rates of complications were investigated. The EEA gave 14% complications because of the frequent failure (33%) of the anastomosis after low anterior resection. The reasons for failure were incomplete rings, colonic wall damage and too short rectal stumps. The use of the EEA in esophago-jejunostomy and esophago-gastrostomy was safe and the postoperative course uneventful. The GIA was used in intestinal and colonic surgery and was pleasant and quick to use (right hemicolectomy: 1 hour 40 minutes; sigmoid resection: 1 hour 45 minutes). Complications occurred in the intestine (6%) and colon (7%). Only with GIA stapled anastomoses was there a risk of hemorrhage (2.5%). The incidence of anastomotic leakage (all staplers) was 3.6%; the stapler was responsible for a 2.0% mortality. Weighing up the indications and contraindications of stapling devices, this method presents an advantageous but not indispensable method in gastrointestinal surgery.

Adult↗

PubMedDate not supplied

Polydioxanone in vascular surgery. First experience with an absorbable suture in femoro-popliteal bypass.

The use of synthetic absorbable monofilament suture material (polydioxanone, PDS), is described for operative vascular surgery. Six anastomoses in three femoro-popliteal (tibial) vein bypass operations were performed. Angiographical control was carried out, when absorption was in progress (after a period of five months) or totally completed (within six months), and showed no dilatation or aneurysm formation at the suture line. One anastomosis was excised five months after the first intervention. Histological examination showed fragmented suture material and slight tissue reaction. Suture material characteristics in respect of tensile strength, pliability, knotting properties and visibility were judged critically.

Aged↗