Agustos 2021
Laparoskopik cerrahide izoperistaltik intra-korporeal çift lineer stapler anastomoz: Erken oral beslenme; hizli, kolay ve güvenilir teknik
Isoperistaltic intracorporeal double linear stapler anastomosis in laparascopic surgery: Early oral nutrition; a fast, easy, and reliable technique
- Ana Sayfa
- Sayılar
- Agustos 2021
- Laparoskopik cerrahide izoperistaltik intra-korporeal çift lineer stapler anastomoz: Erken oral beslenme; hizli, kolay ve güvenilir teknik...
Saglik Bilimleri Üniversitesi, Ankara Sehir Hastanesi Saglik Uygulama ve Arastirma Merkezi, 2Gastroenteroloji Cerrahisi Klinigi, Ankara
Özet
Giris ve Amaç: Gastrointestinal sistem kanser cerrahisinde minimal invaziv cerrahi; kisa dönem derlenme ve daha iyi fonksiyonel sonuçlarla birlikte, mide ve kolon kanseri cerrahisinde uzun dönem onkolojik sonuçlardan ödün vermeden uygulanmaktadir. Bu çalismada amacimiz laparoskopik radikal distal intrakorporeal Billroth II ve laparoskopik sag- sol hemikolektomi sonrasinda izoperistaltik ileokolik ve izoperistaltik kolokolik çift lineer stapler teknigi ile anastomoz yaptigimiz hastalari incelemektir. Gereç ve Yöntem: Çalismaya Aralik 2019- Mart 2021 tarihleri arasinda klinigimizde çift lineer stapler teknigi ile anastomoz yaptigimiz 13 hasta dahil edildi. Tüm prosedürler total laparoskopik olarak gerçeklesti ve anastomozlar intrakorporeal olarak stapler yardimi ile tamamlandi. Bulgular: Tariflenen anastomozu uyguladigi- miz 13 hastanin mean yas degeri 51.31 ± 16.84 idi. Hastalarin 10’u (%76.9) erkek ve 3’ü (%23.1) kadin idi. Anastomozun median yapilis süresi 12.38 ± 3.09 dakika idi. Median ameliyat süresi 13 dakika (minimum-maksimum), (8-19 dakika) idi. Anastomoz esnasinda ameliyat sonrasi takiplerde 12 (%92.3) hastada herhangi bir komplikasyon gelismez iken 1 (7.7.%) hastada anastomoz hattinda kanama gözlendi. Kanama medikal takip ile tedavi edildi. Hiçbir hastaya relaparotomi gerekmedi. Sonuç: Laparoskopi sonrasinda rekonstrüksiyon asamasinda bu stapler ile anastomoz tekniginin hizli ve kolay olarak uygulanabilir bir yöntem oldugu; anastomoz kaçagi açisindan da güvenle uygulanabilecegi görüsündeyiz
Abstract
Background and Aims: Minimally invasive surgery is associated with short-term recovery and better functional results in gastrointestinal system cancer surgery. It is applied in gastric and colon cancer surgery without compromising long-term oncological results. This study examines patients who underwent anastomosis with the double linear stapler technique with isoperistaltic intracorporeal ileocolic and isoperistaltic colocolic anastomosis after laparoscopic radical distal Billroth 2 and laparoscopic right-left hemicolectomy. Material and Method: Thirteen patients who underwent anastomosis with the double linear stapler technique in our clinic between December 2019 and March 2021 were included in this study. All procedures were performed entirely laparoscopically, and anastomoses were completed intracorporeally with the assistance of a stapler. Results: The mean age of 13 patients in whom we performed the described anastomosis was 51.31 ± 16.84 years. Ten (76.9%) patients were male, and three (23.1%) were female. The median duration of the anastomosis was 12.38 ± 3.09 minutes. The median operation time was 13 minutes (min-max) (8–19 minutes). While no perioperative complications developed in 12 (92.3%) patients during anastomosis, perioperative intraluminal hemorrhage was observed in one (7.7%) patient. This hemorrhage was treated medically with follow-up. No relaparotomy was required for any patient. Conclusion: This stapler anastomosis technique can be performed quickly and easily in the reconstruction phase after laparoscopy. We think it can be done safely concerning anastomotic leakage
