Laparoskopik cerrahide izoperistaltik intra-korporeal çift lineer stapler anastomoz: Erken oral beslenme; hızlı, kolay ve güvenilir teknik

Öz

Giriş ve amaç: Gastrointestinal sistem kanser cerrahisinde minimal invaziv cerrahi; kısa dönem derlenme ve daha iyi fonksiyonel sonuçlarla birlikte, mide ve kolon kanseri cerrahisinde uzun dönem onkolojik sonuçlardan ödün vermeden uygulanmaktadır. Bu çalışmada amacımız laparoskopik radikal distal intrakorporeal Billroth II ve laparoskopik sağ-sol hemikolektomi sonrasında izoperistaltik ileokolik ve izoperistaltik kolokolik çift lineer stapler tekniği ile anastomoz yaptığımız hastaları incelemektir. Gereç ve Yöntem: Çalışmaya Aralık 2019- Mart 2021 tarihleri arasında kliniğimizde çift lineer stapler tekniği ile anastomoz yaptığımız 13 hasta dahil edildi. Tüm prosedürler total laparoskopik olarak gerçekleşti ve anastomozlar intrakorporeal olarak stapler yardımı ile tamamlandı. Bulgular: Tariflenen anastomozu uyguladığımız 13 hastanın mean yaş değeri 51.31 ± 16.84 idi. Hastaların 10’u (%76.9) erkek ve 3’ü (%23.1) kadın idi. Anastomozun median yapılış süresi 12.38 ± 3.09 dakika idi. Median ameliyat süresi 13 dakika (minimum-maksimum), (8-19 dakika) idi. Anastomoz esnasında ameliyat sonrası takiplerde 12 (%92.3) hastada herhangi bir komplikasyon gelişmez iken 1 (7.7.%) hastada anastomoz hattında kanama gözlendi. Kanama medikal takip ile tedavi edildi. Hiçbir hastaya relaparotomi gerekmedi. Sonuç: Laparoskopi sonrasında rekonstrüksiyon aşamasında bu stapler ile anastomoz tekniğinin hızlı ve kolay olarak uygulanabilir bir yöntem olduğu; anastomoz kaçağı açısından da güvenle uygulanabileceği görüşündeyiz.

Anahtar Kelimeler

• Laparoskopik cerrahi
• izoperistaltik
• stapler anastomoz
• cerrahi teknik

Isoperistaltic intracorporeal double linear stapler anastomosis in laparascopic surgery: Early oral nutrition; a fast, easy, and reliable technique

Öz

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.

Anahtar Kelimeler

• Laparoscopic surgery
• isoperistaltic
• stapler anastomosis
• surgical technique

Kaynakça

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