Intraoperative hemostasis and wound healing in intestinalanastomoses using the ILA stapling device

Berman, Scott S.; Hashizume, Makoto; Yang, Yunlei; DuPree, Joseph; Matsumoto, Teruo

doi:10.1016/s0002-9610(88)80127-2

Cited by 6 publications

(5 citation statements)

References 10 publications

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“…Hemorrhage in 2 of 15 cats required blood transfusions after stapled colectomy 8 . The B configuration of staples can allow some large vessels to remain patent within the staple line 9 . Oversewing the staple line apparently did not provide hemostasis in this horse.…”

Section: Discussionmentioning

confidence: 97%

Life‐threatening hemorrhage from enterotomies and anastomoses in 7 horses

et al. 2003

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Section: Discussionmentioning

confidence: 97%

Life‐threatening hemorrhage from enterotomies and anastomoses in 7 horses

et al. 2003

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“…Currently, many surgeons are using staplers for performing anastomoses because they are safe and time saving; these advanced instruments facilitated the novel procedure in this study as well. To date, several studies have shown that using advanced stapling devices reduces the incidence of complications, such as leakage and bleeding; in addition, stapling makes anastomosis of the intestine easier and more secure than hand sewing [ 16 17 18 ]. The advantage of using a stapling device is particularly evident in complicated procedures, such as the conventional R-Y reconstruction that requires many anastomoses.…”

Section: Discussionmentioning

confidence: 99%

A Novel Roux-en-Y Reconstruction Involving the Use of Two Circular Staplers after Distal Subtotal Gastrectomy for Gastric Cancer

et al. 2017

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PurposeAlthough Roux-en-Y (R-Y) reconstruction after distal gastrectomy has several advantages, such as prevention of bile reflux into the remnant stomach, it is rarely used because of the technical difficulty. This prospective randomized clinical trial aimed to show the efficacy of a novel method of R-Y reconstruction involving the use of 2 circular staplers by comparing this novel method to Billroth-I (B-I) reconstruction.Materials and MethodsA total of 118 patients were randomly allocated into the R-Y (59 patients) and B-I reconstruction (59 patients) groups. R-Y anastomosis was performed using two circular staplers and no hand sewing. The primary end-point of this clinical trial was the reflux of bile into the remnant stomach evaluated using endoscopic and histological findings at 6 months after surgery.ResultsNo significant differences in clinicopathological findings were observed between the 2 groups. Although anastomosis time was significantly longer for the patients of the R-Y group (P<0.001), no difference was detected between the 2 groups in terms of the total surgery duration (P=0.112). Endoscopic findings showed a significant reduction of bile reflux in the remnant stomach in the R-Y group (P<0.001), and the histological findings showed that reflux gastritis was more significant in the B-I group than in the R-Y group (P=0.026).ConclusionsThe results of this randomized controlled clinical trial showed that compared with B-I reconstruction, R-Y reconstruction using circular staplers is a safe and feasible procedure. This clinical trial study was registered at www.ClinicalTrials.gov (registration No. NCT01142271).

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“…In particular, recent development of the device has led to reduced complications, like leakage and bleeding, and its range of use has been extended. (12-14) However, anastomosis using staples for jejunojejunostomy in Roux en Y reconstruction is not easy, and most surgeons have used a hand-sewn technique. In this study, we developed a new technique in which jejunojejunostomy was easily performed by passage of a 21 mm diameter circular stapler through the Roux limb 30 to 40 cm from the divided distal end of the jejunum in order to make the anastomosis.…”

Section: Discussionmentioning

confidence: 99%

Efficacy of Roux-en-Y Reconstruction Using Two Circular Staplers after Subtotal Gastrectomy: Results from a Pilot Study Comparing with Billroth-I Reconstruction

et al. 2011

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PurposeThe Roux en Y method has rarely been performed due to longer operation time and high risk of complication, despite several merits including prevention of bile reflux. We conducted a retrospective review of the result of Roux en Y reconstruction using two circular staplers after subtotal gastrectomy.Materials and MethodsFrom December 2008 to May 2009, a total of 26 patients underwent Roux en Y reconstruction using two circular staplers after subtotal gastrectomy, and seventy-two patients underwent Billroth-I reconstruction. Roux en Y anastomosis was performed using two circular staplers without hand sewing anastomosis. We compared clinicopathologic features and surgical outcomes between the two groups. All patients underwent gastrofiberscopy between six and twelve months after surgery to compare the bile reflux.ResultsNo significant differences in clinicopathologic findings were observed between the two groups, except for the rate of minimal invasive surgery (P=0.004) and cancer stage (P=0.002). No differences in the rate of morbidity (P=0.353) and admission duration (P=0.391) were observed between the two groups. Gastrofiberscopic findings showed a significant reduction of bile reflux in the remnant stomach in the Roux en Y group (P=0.019).ConclusionsWhen compared with Billroth-I reconstruction, Roux en Y reconstruction using the double stapler technique was found to reduce bile reflux in the remnant stomach without increasing postoperative morbidity. Based on these results, we planned to begin a randomized controlled clinical trial for comparison of Roux en Y reconstruction using this method with Billroth-I anastomosis.

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Intraoperative hemostasis and wound healing in intestinalanastomoses using the ILA stapling device

Cited by 6 publications

References 10 publications

Life‐threatening hemorrhage from enterotomies and anastomoses in 7 horses

Life‐threatening hemorrhage from enterotomies and anastomoses in 7 horses

A Novel Roux-en-Y Reconstruction Involving the Use of Two Circular Staplers after Distal Subtotal Gastrectomy for Gastric Cancer

Efficacy of Roux-en-Y Reconstruction Using Two Circular Staplers after Subtotal Gastrectomy: Results from a Pilot Study Comparing with Billroth-I Reconstruction

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