Nahttechniken

  • C. Muller
  • M. Allgower
  • L. F. Hollender
  • Ch. Meyer
  • N. de Manzini
  • J. R. Siewert

Zusammenfassung

Besonders bei Nahten und Anastomosen im Gastrointestinaltrakt ist die Frage der primaren Dichtigkeit einer Wunde wesentlich. Falsch ist es, Dichtigkeit mit einer großen Zahl von stark angezogenen Nahten erreichen zu wollen. Wohl laßt sich damit mechanisch ein primar dichter Wundverschluß erzielen, dies aber auf Kosten des biologisch wichtigeren Faktors der Durchblutung mit der Gefahr einer Gewebenekrose und Anastomosendehiscenz nach einigen Tagen [21, 30]. Normalerweise erfolgt die Verklebung der Serosaflachen in den ersten 4-6 h, wodurch ein erster flu⋅ssigkeits- und gasdichter, aber noch nicht mechanisch belastbarer Verschluß entsteht

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Literatur

  1. 1.
    Allgower M, Hasse J, Herzog B (1971) Colonresektionen Chirurg 42 1PubMedGoogle Scholar
  2. 2.
    Brunius U (1968) Wound healing impairment from sutures A tensiometric and histologic study in the rat Acta Chir Scand 395 3Google Scholar
  3. 3.
    Craig PH et al (1975) A biologic comparison of polyglactin 910 and polyglycolic acid synthetic absorbable sutures Surg Gynec Obstet 141 1PubMedGoogle Scholar
  4. 4.
    Dardik H, Dardik I, Laufman H (1971) Clinical use of polyglycolic acid polymer as a new absorbable synthetic suture Am J Surg 121 656PubMedCrossRefGoogle Scholar
  5. 5.
    De Vito RV (1965) Healing of wounds North Am Surg Clin 45 441Google Scholar
  6. 6.
    Echeverria EA, Jimenez J (1970) Evaluation of an absorbable synthetic suture material Surg Gynecol Obstet 131 1PubMedGoogle Scholar
  7. 7.
    Everett WG (1970) Suture materials in general surgery Prog Surg 8 14PubMedGoogle Scholar
  8. 8.
    Fellows NM et al (1951) Suture strength and healing strength of end to end intestinal anastomoses Surg Forum 3 111Google Scholar
  9. 9.
    Forester JC, Zederfeldt B, Hayes TL, Hunt TK (1970) Tape-closed and sutured wounds A comparison by tensiometry and scanning electron microscopy Br J Surg 57 129CrossRefGoogle Scholar
  10. 10.
    Gambee LP (1951) A single-layer open intestinal anastomosis applicable to the small as well as to the large intestine West J Surg 59 1PubMedGoogle Scholar
  11. 11.
    Getzen LC (1966) Clinical use of everted intestinal anastomosis Surg Gynecol Obstet 123 1027PubMedGoogle Scholar
  12. 12.
    Harder F, Kull C (1987) Fortlaufende einreihige Darmanastomose Chirurg 58 269Google Scholar
  13. 13.
    Herrmann JB, Woodward SC, Pulaski EJ (1964) Healing of colonic anastomosis in the rat Surg Gynecol Obstet 119 269PubMedGoogle Scholar
  14. 14.
    Herrmann JB, Kelly RG, Higgins GA (1970) Polyglycolic acid sutures Arch Surg 100 486PubMedCrossRefGoogle Scholar
  15. 15.
    Herztler JH, Tuttle WM (1952) Experimental method for an everting and end-to-end anastomosis in the gastrointestinal tract Arch Surg 65 398CrossRefGoogle Scholar
  16. 16.
    Herzog B (1974) Die Darmnaht Huber, Bern Stuttgart WienGoogle Scholar
  17. 17.
    Holmlund DEW (1974) Knot properties of surgical suture material Acta Chir Scand 140 355PubMedGoogle Scholar
  18. 18.
    Houdart R, Lavergne A, Valleur P, Hautefeuille P (1986) Polydioxanone in digestive surgery Am J Surg 152 268PubMedCrossRefGoogle Scholar
  19. 19.
    Hudemann H (1959) Chirurgisches Nahtmaterial Fischer, JenaGoogle Scholar
  20. 20.
    Katz AR, Turner RJ (1970) Evaluation of tensile and absorption properties of polyglycolic acid sutures Surg Gynecol Obstet 131 701PubMedGoogle Scholar
  21. 21.
    Keill RH et al (1973) Abdominal wound dehiscence Arch Surg 106 573PubMedCrossRefGoogle Scholar
  22. 22.
    Lunstedt B, Thiede A (1983) Polydioxanon (PDS)-ein neues monofiles synthetisches, absorbierbares Nahtmaterial Chirurg 54 103Google Scholar
  23. 23.
    Muller C, Allgower M (1975) Komplikationen des Bauchdeckenverschlusses und ihre Vermeidung Helv Chir Acta 42 819Google Scholar
  24. 24.
    Nockemann PF (1975) Die chirurgische Naht Thieme, StuttgartGoogle Scholar
  25. 25.
    Ordmann LJ, Gillman T (1966) Studies of healing of cutaneous wounds Arch Surg 93 857CrossRefGoogle Scholar
  26. 26.
    Postlethwait RW (1970) Polyglycolic acid suture Arch Surg 101 489PubMedCrossRefGoogle Scholar
  27. 27.
    Postlethwait RW (1970) Long-term comparative study of nonabsorbable sutures Ann Surg 171 892PubMedCrossRefGoogle Scholar
  28. 28.
    Postlethwait RW, Schauble JF, Dillon ML, Morgan J (1959) Wound healing II An evaluation of surgical suture material Surg Gynecol Obstet 108 555PubMedGoogle Scholar
  29. 29.
    Ray JA, Doddi N, Regula D, Williams JA, Melveger A (1981) Polydioxanone (PDS), a novel monofilament synthetic absorbable suture Surg Gynecol Obstet 153 497PubMedGoogle Scholar
  30. 30.
    Sanders RJ, DiClementi D, Ireland K (1977) Principles of abdominal wound closure I Animal studies Arch Surg 112 1084Google Scholar
  31. 31.
    Shouldice EE, Glassow F, Black N (1961) A study of sinuses occurring after the use of silk only, wire only or a combination of the two Can Med Assoc J 84 576PubMedGoogle Scholar
  32. 32.
    Trimbos JB, Rijssel EV von, Klopper PJ (to be published) Performance of sliding knots in monofilament and multifilament suture material Obstet GynecolGoogle Scholar
  33. 33.
    van Winkle W Jr, Hastings C (1972) Considerations in the choice of suture material for various tissues Surg Gynecol Obstet 135 113PubMedGoogle Scholar
  34. 34.
    Varma S, Ferguson HL, Breen H, Lumb WF (1974) Comparison of seven suture materials in infected wounds — an experimental study J Surg Res 17 165PubMedCrossRefGoogle Scholar
  35. 1.
    Adloff M, Arnaud JP, Oilier JC (1984) Etude critique et bilan des sutures mécaniques dans le domaine de la chirurgie rectale In Actualités chirurgicales Chirurgie abdominale et digestive Sutures digestives mécaniques Masson, paris, pp 177–182Google Scholar
  36. 2.
    Androsov PI (1970) Experience in the application of the instrumental mechanical suture in surgery of the stomach und rectum Acta Chir Scand 136 57PubMedGoogle Scholar
  37. 3.
    Bardini R, Ancona E, Battaglia G, Peracchia A (1984) Comparaison entre les anastomoses mécaniques et manuelles en chirurgie oesophagienne In Actualités chirurgicales Chirurgie abdominale et digestive Sutures digestives mécaniques Masson, paris, pp 173–174Google Scholar
  38. 4.
    Beart RW, Kelly KA (1981) Randomized prospective evaluation of the E E A stapler for colorectal anastomoses Am J Surg 141 143–147PubMedCrossRefGoogle Scholar
  39. 5.
    Behl PR, Holden MP, Brown AH (1983) Three years experience with oesophageal stapling device Ann Surg 198 134–136PubMedCrossRefGoogle Scholar
  40. 6.
    Bolten RA, Britton DC (1980) Restorative surgery of the rectum with a circumferential stapler Lancet I 850–856CrossRefGoogle Scholar
  41. 7.
    Brennan SS, Pickford IR, Evans M, Pollock AV (1982) Stapler or sutures for colonic anastomoses — a controlled clinical trial Br J Surg 69 722–724PubMedCrossRefGoogle Scholar
  42. 8.
    Cady J, Godfroy J, Sibaud O (1980) La désunion anastomotique en chirurgie colique et rectale Étude comparative des procédés de suture manuelle et mécanique a propos d’une série de 149 opérations Ann Chir 34 350–356PubMedGoogle Scholar
  43. 9.
    Cohen Z, Myers E, Langer B, Taylor B, Railton RH, Jamieson C (1983) Double stapling technique for low anterior resection Dis Colon Rectum 26 231PubMedCrossRefGoogle Scholar
  44. 10.
    Denecke H, Wirsching R (1984) Colorectale Anastomosen Chirurg 55 638–644Google Scholar
  45. 11.
    De Ruiter P (1983) Staplers, two-and one-layer manual suturing in gastrointestinal surgery A retrospective study of 553 patients Neth J Surg 35 150–154PubMedGoogle Scholar
  46. 12.
    Dorsey JS, Stone RM (1981) Colorectal anastomosis with a surgical stapler Can J Surg 24 255–256Google Scholar
  47. 13.
    Dunn DH, Robbins P, Decanini C (1978) A comparison of stapled and hand-sewn colonic anastomoses Dis Colon Rectum 21 636–639PubMedCrossRefGoogle Scholar
  48. 14.
    Edis A J (1980) Pitfalls in gastrointestinal stapling In Maingot R (ed) Abdominal operations Appleton Century Crofts, New York, pp 2210–2220Google Scholar
  49. 15.
    Fasching W, Moritz E (1980) Zirkulare Klammernahtanastomosen im Magen-Darm-Trakt mit den Klammernahtgeraten SPTU und EEA Chirurg 51 644PubMedGoogle Scholar
  50. 16.
    Fékété F, Breil P (1984) Utilisation des sutures mécaniques dans la chirurgie de l’oesophage 200 anastomoses In Actualités Chirurgicales Chirurgie abdominale et digestive, Masson, paris, pp 170–173Google Scholar
  51. 17.
    Fékété F, Breil P, Ronsse H, Wessely JY (1981) Technique et premiers résultats des anastomoses oesogastriques intrathoraciques à la EEA Ann Chir 35 697–702Google Scholar
  52. 18.
    Goligher JC, Lee PWG, Simpkins KC, Lintott DJ (1977) A controlled comparison of one-and two-layer techniques of suture for high and low colorectal anastomoses Br J Surg 64 609–614PubMedCrossRefGoogle Scholar
  53. 19.
    Goligher JC, Lee PWG, Macfie J (1979) Experience with the russian model 249 suture gun for anastomosis of the rectum Surg Gynecol Obstet 148 517–524Google Scholar
  54. 20.
    Gordon PH, Vasilevsky CA (1984) Experience with stapling in rectal surgery Surg Clin North Am 64 555–566PubMedGoogle Scholar
  55. 21.
    Graffner H, Fredling P, Olsson S, Oscarson J, Peterson B (1983) Protective colostomy in low anterior resection of the rectum using the EEA stapling instrument Dis Colon Rectum 26 82–87CrossRefGoogle Scholar
  56. 22.
    Hollender LF, Meyer C, Blanchot Ph, Garcia Castellanos J (1980) Les sutures mécaniques en chirurgie gastrolntestinale Bull Acad Natl Méd (paris) 164 260–269Google Scholar
  57. 23.
    Hollender LF, Meyer C, Keller D, Cordeiro F (1981) Le »tout mécanique« dans la gastrectomie totale avec jéjunoplastie Nouv Presse Méd 10 2901–2903PubMedGoogle Scholar
  58. 24.
    Hultl H (1911) Chirurgisches Nahtinstrument fur Magen-und Darmnaht Fischer, BudapestGoogle Scholar
  59. 25.
    Jameson L, Chassin MD, Kenneth M et al (1978) The stapled gastrointestinal tract anastomosis Incidence of postoperative complications compared with the sutured anastomosis Ann Surg 188 689–696CrossRefGoogle Scholar
  60. 26.
    Kreiskother E, Arbogast R, Wasmer HP (1985) Die bimaschinelle Rectumanastomose („Double stapling Technik“) Chirurg 56 179–182PubMedGoogle Scholar
  61. 27.
    Lagache G (1982) La suture mécanique en chirurgie digestive A propos d’une étude multicentnque de 4822 cas Chirurgie 108 578–582Google Scholar
  62. 28.
    Ling L, Broome A, Ryden S (1979) Low anterior resection using stapling instrument Acta Chir Scand 145 487–489PubMedGoogle Scholar
  63. 28a.
    Meyer C, Hollender LF (1986) Chirurgie colique d’urgence Masson, parisGoogle Scholar
  64. 29.
    Parc R, Cugnenc Ph, Levy E, Huguet C, Loygue J (1981) Les suites opératoires précoces des résections intestinales suivies d’anastomoses colo-coliques ou colorectales A propos de 523 observations Ann Chir 35 69–82PubMedGoogle Scholar
  65. 30.
    Pelissier E, Bachour A (1984) Bilan de 172 anastomoses colo-rectales manuelles et mécaniques Chirurgie 110 650–654PubMedGoogle Scholar
  66. 31.
    Petz AV (1924) Zur Technik der Magenresektion Ein neuer Magen-Darm-Nahapparat Zentralbl Chir 51 179–188Google Scholar
  67. 32.
    Ravitch MM (1983) Varieties of stapler anastomoses in rectal resection Surg Clin North Am 64 543–554Google Scholar
  68. 33.
    Reiling RB, Reiling WA, Bernie WA, Huffer AB, Perkins NC, Elliot DW (1980) Prospective controlled study of gastrointestinal stapled anastomoses Am J Surg 139 147–152PubMedCrossRefGoogle Scholar
  69. 34.
    Sannohe Y, Hiratsuka R, Doki K (1981) Single layer suture by normal and mechanical stapling technique in esophagojejunostomy after total gastrectomy Am J Surg 142 403–406PubMedCrossRefGoogle Scholar
  70. 35.
    Scher KS, Scott-Conner C, Ong WT (1982) A comparison of stapled and sutured anastomoses in gastric operations Surg Gynecol Obstet 154 548–552PubMedGoogle Scholar
  71. 36.
    Steichen FM, Ravitch MM (1984) Stapling in surgery Year Book Medical Chicago, LondonGoogle Scholar
  72. 37.
    Stoppa R, Degroote D, Warlaumont Ch, Henry X (1934) Les pièges des anastomoses circulaires mécaniques Press Med 13 281–282Google Scholar
  73. 38.
    Tanos G, Gewalt R (1985) Colon-Anastomose ohne Naht und Fremdmaterial Chirurg 56 284–289PubMedGoogle Scholar
  74. 39.
    Thiede A, Jostarndt L, Troidl H, Poser HL, Bertz U, Hamelmann H (1981) Der Wert der zirkulären maschinellen Colon-und Rectumanastomose (EEA) Chirurg 52 30–35PubMedGoogle Scholar
  75. 40.
    Thiede A, Schubert G, Poser HL, Jostarndt L (1984) Zur Technik der Rectumanastomosen bei Rectumresektionen Eine kontrollierte Studie Instrumentelle Naht versus Handnaht Chirurg 55 326–335Google Scholar
  76. 41.
    Trollope ML, Cohen RG, Lee RH, Cannon WB, Marzoni FA, Cressman RD (1986) A 7 year experience with low anterior sigmoid resections using the EEA Stapler Am J Surg 152 11–14CrossRefGoogle Scholar
  77. 42.
    Weil PH, Scherz H (1981) Comparison of stapled and hand-sutured gastrectomies Arch Surg 116 14–16PubMedCrossRefGoogle Scholar
  78. 43.
    Welter R, Psalmon F, Charlier A (1985) Description des appareils, raisonnement et procédés élémentaires In Welter R, Patel JC (eds) Chirurgie mécanique digestive Masson, paris pp 27–47Google Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 1990

Authors and Affiliations

  • C. Muller
  • M. Allgower
  • L. F. Hollender
  • Ch. Meyer
  • N. de Manzini
  • J. R. Siewert

There are no affiliations available

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