PDF(Pubmed)
Abstract：
To optimize the efficiency of ileocolic anastomosis following right hemicolectomy, several variations of the surgical technique have been tested. These include performing the anastomosis intra- or extracorporeally or performing a stapled or hand-sewn anastomosis. Among the least studied is the configuration of the two stumps (i.e., isoperistaltic or antiperistaltic) in the case of a side-to-side anastomosis. The purpose of the present study is to compare the isoperistaltic and antiperistaltic side-to-side anastomotic configuration after right hemicolectomy by reviewing the relevant literature. High-quality literature is scarce, with only three studies directly comparing the two alternatives, and no study has revealed any significant differences in the incidence of anastomosis-related complications such as leakage, stenosis, or bleeding. However, there may be a trend towards an earlier recovery of intestinal function following antiperistaltic anastomosis. Finally, existing data do not identify a certain anastomotic configuration (i.e., isoperistaltic or antiperistaltic) as superior over the other. Thus, the most appropriate approach is to master both anastomotic techniques and select between the two configurations based on each individual case scenario.
摘要：
为了优化右半结肠切除术后回肠吻合的效率，已经测试了手术技术的几种变体。这些包括在内部或外部执行吻合或执行缝合或手工缝合吻合。研究最少的是两个树桩的配置(即，等周或抗蠕动）在左右吻合的情况下。本研究的目的是通过查阅相关文献，比较右半结肠切除术后等周和抗蠕动侧吻合构型。高质量的文学是稀缺的，只有三项研究直接比较了这两种选择，并且没有研究显示吻合相关并发症如渗漏的发生率有任何显著差异，狭窄,或出血。然而,抗蠕动吻合术后，肠功能可能有更早恢复的趋势。最后,现有数据无法识别某种吻合构型(即，等周或反蠕动)优于其他。因此，最合适的方法是掌握两种吻合技术，并根据每种情况在两种配置之间进行选择。
