Curved cutter stapler vs. linear stapler in rectal cancer surgery: a pilot prospective randomized study.
ABSTRACT This study aimed to compare the safety and technical accessibility of linear stapler and curved cutter stapler (CCS) during mid to low rectal cancer surgery.
Between April and November 2006, 60 patients were randomly assigned to either linear staplers (DST TA; United States Surgical, Tyco Healthcare Group LP, Norwalk, CT) or the CCS (Contour Curved Cutter Stapler(R); Ethicon Endo-Surgery, Inc., Cincinnati, OH) during low anterior resection for mid to low rectal cancers.
There were no significant differences in age, gender, body mass index, and mean carcinoembryonic antigen level between the two groups. Distal resection margin was longer in the CCS group as compared with the linear stapler group but did not reach statistical significance (24.7 vs. 20.8 mm, P = 0.065). There was no difference in the incidence of postoperative complications.
In this study, both the CCS and linear staplers were satisfactory devices for securing the distal rectum during low anterior resection in mid to low rectal cancers.
- SourceAvailable from: Victor W Fazio[show abstract] [hide abstract]
ABSTRACT: In a prospective open study of the Proximate ILS circular stapler, the results of 125 intestinal anastomoses in 119 patients were reviewed. Intraoperative leakage was observed in five instances, after intraluminal povidone instillation, necessitating suture-line reinforcement. In three instances, incomplete tissue rings (donuts) were found. Temporary fecal diversion was used in seven of 84 patients with anastomoses made to the rectum or anal canal. Roentgenographic assessment of 79 of these anastomoses using Gastrografin demonstrated a leak in three (3.8%). There was one clinical leak (0.9%) in the series. Three patients died (2.5%), none from anastomotic complications. Transient anastomotic strictures were found in three of 82 operative survivors where the anastomosis was within range of the proctoscope. There were no instances of significant hemorrhage from the anastomosis. No patient required anastomotic revision, and of the 51 survivors of cancer surgery where proctoscopy could evaluate the anastomosis, there was no evidence of local recurrence in the period of follow up (mean 16.3 months). The authors conclude: that the Proximate ILS is a safe, reliable and effective instrument for construction of intestinal anastomoses.Annals of Surgery 02/1985; 201(1):108-14. · 6.33 Impact Factor
- [show abstract] [hide abstract]
ABSTRACT: The short term results of colorectal anastomosis using the Russian SPTU and American EEA circular staplers are compared. Anastomoses with these stapling devices were attempted in 61 patients between October 1978 and December 1980. In 1 patient the stapling method failed at operation, so that 60 patients had a stapled anastomosis as their definitive form of anastomosis. Of these, 31 were stapled using the Russian SPTU device and 29 using the American EEA device. Parameters of age, indication for operation, surgical assessment of curability, tumour stage and distance from the anal verge are compared to demonstrate similarity of the groups. Practical aspects of the use of the staplers are discussed. Local complications of dehiscence, anastomotic haemorrhage, stenosis and fistula formation occurred in 17 patients. Complications related specifically to the stapling procedure occurred with similar frequency in both groups: 8 patients treated with the SPTU stapler and 9 patients treated with the EEA stapler. No significant advantage was demonstrated for either stapler with respect to overall local complications; however, the authors have found the EEA stapler both easier to use and easier to maintain.British Journal of Surgery 02/1982; 69(1):19-22. · 4.84 Impact Factor
- [show abstract] [hide abstract]
ABSTRACT: The development of laparoscopic linear staplers has enabled minimally invasive approaches to bariatric surgery, but there have been no comparison studies of the two current 6-row devices. We report our experience with a prospective randomized comparison of 6-row linear staplers during laparoscopic Roux-en-Y gastric bypass (LRYGBP). From January to March 2003, 100 patients were randomly assigned to undergo LRYGBP with either an Endo-GIA Universal 6-row stapler (USSC) or the ETS-Flex 6-row stapler (Ethicon). Mean preoperative BMI was 49+/-8 for 50 Endo-GIA patients, and 49+/-7 for 50 ETS-Flex patients. Parameters measured included quantity of cartridges, handles, hemoclips, estimated blood loss, misfires, OR time, postoperative leaks and bleeds, and cost. Mean follow-up was 135 days (range 90- 180). The ETS-Flex group experienced significantly more misfires (28% vs 2%, P <.001), hemoclips applied (30+/-9 vs 21+/-7, P <.001), estimated blood loss (132+/-56 vs 100+/-32 ml, P <.001) and OR time (66+/-19 vs 58+/-13 mins, P <.02) compared with the Endo-GIA group respectively. There was one postoperative leak associated with the ETS-Flex group and two postoperative bleeds with the Endo-GIA group, which were not a significant differences. The Endo-GIA group averaged $319 more per case for staple cost. While the ETS-Flex stapler was less expensive, it was associated with more technical failures requiring surgeon intervention to reduce potential patient morbidity, compared with the Endo-GIA.Obesity Surgery 01/2004; 13(6):855-9; discussion 860. · 3.10 Impact Factor