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Serosal laceration during firing of powered linear stapler is a predictor of staple malformation

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Title: Serosal laceration during firing of powered linear stapler is a predictor of staple malformation
Other Titles: Laceration predicts staple malformation
Authors: Matsuzawa, Fumihiko Browse this author
Homma, Shigenori Browse this author →KAKEN DB
Yoshida, Tadashi Browse this author →KAKEN DB
Konishi, Yuji Browse this author
Shibasaki, Susumu Browse this author
Ishikawa, Takahisa Browse this author
Kawamura, Hideki Browse this author →KAKEN DB
Takahashi, Norihiko Browse this author
Iijima, Hiroaki Browse this author
Taketomi, Akinobu Browse this author →KAKEN DB
Keywords: serosal laceration
staple malformation
powered linear stapler
optimal formation rate
slow stapling
Issue Date: 1-Dec-2017
Publisher: SAGE Publications
Journal Title: Surgical innovation
Volume: 24
Issue: 6
Start Page: 590
End Page: 597
Publisher DOI: 10.1177/1553350617733350
PMID: 28962536
Abstract: Background. Although several types of staplers have been developed, staple-line leaks have been a great problem in gastrointestinal surgery. Powered linear staplers were recently developed to further reduce the risk of tissue trauma during laparoscopic surgery. The aim of this study was to identify the factors that predict staple malformation and determine the effect of precompression and slow firing on the staple formation of this novel powered stapling method. Methods. Porcine stomachs were divided using an endoscopic powered linear stapler with gold reloads. We divided the specimens into 9 groups according to the precompression time (0/60/180 seconds) and firing time (0/60/180 seconds). The occurrence and length of laceration and the shape of the staples were evaluated. We examined the factors influencing successful stapling and investigated the key factors for staple malformation. Results. Precompression significantly decreased the occurrence and length of serosal laceration. Precompression and slow firing significantly improved the optimal stapling formation rate. Univariate analysis showed that the precompression time (0 seconds), firing time (0 seconds), and presence of serosal laceration were significantly associated with a low optimal formation rate. Multivariate analysis showed that these three factors were associated independently with low optimal formation rate and that the presence of serosal laceration was the only factor that could be detected during the stapling procedure. Conclusions. We have shown that serosal laceration is a predictor of staple malformation and demonstrated the importance of precompression and slow stapling when using the powered stapling method.
Rights: The final, definitive version of this paper has been published in Surgical Innovation, volume 24, issue 6, December 1, 2017 published by SAGE Publishing, All rights reserved.
Type: article (author version)
Appears in Collections:医学院・医学研究院 (Graduate School of Medicine / Faculty of Medicine) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)

Submitter: 松澤 文彦

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