Gastrointestinal sistemde uygulanan anastomozda katlanabilir stapler ile sirküler stapler etkinliğinin karşılaştırılması
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Dosyalar
Tarih
2022
Yazarlar
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Yayıncı
Selçuk Üniversitesi, Tıp Fakültesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Amaç: Stapler kullanımı son yıllarda çok tercih edilse de mevcut staplerlerin boyutları itibariyle hasar verme, bazı operasyonlarda ek sütur gerektirmesi, mide ve özofagus cerrahisinde batın dışında yerleştirme yapılamaması dezavantajları arasındadır. Bu sebeplerle stapler mekanizmasında geliştirmeler yapılmıştır. Bu çalışmada da yeni geliştirilen katlanabilir anvile sahip sirküler staplerin mevcut staplere göre etkinliğinin araştırılması planlanmıştır. Gereç ve Yöntem: Bu çalışma Selçuk Üniversitesi Deneysel Tıp Araştırma ve Uygulama Merkezinin laboratuvarında yetiştirilmiş 12 adet New Zealand albino türü yetişkin dişi tavşanlara uygulanan cerrahi müdahaleler sonucu elde edilmiştir. Cerrahi müdahale sonunda anastomoz patlama basıncına ölçülüp kaydedilmiş ardından anastomoz hattının üçer cm etrafından doku çıkarılmıştır. Elde edilen piyesler Selçuk Üniversitesi Tıp Fakültesi Tıbbi Patoloji laboratuvarında çalışılmıştır. Elde edilen bulgular IBM SPSS 22.0 programında değerlendirilmiştir. Bulgular: Tavşanlar katlanabilir anvile sahip sirküler staplerin kullanıldığı çalışma grubu ve standart sirküler staplerin kullanıldığı kontrol grubu olarak ikiye ayrıldı. Anastomoz hattının iyileşmesini değerlendiren mekanik inceleme yöntemlerinden anastomoz patlama basıncı ile değerlendirme yapıldı. Anastomoz patlama basınçları karşılaştırıldığında; her iki grup arasında anlamlı bir farklılık bulunmadı. Histopatolojik değerlendirmelerde "inflamatuar granülom varlığı ve granülasyon dokusu oluşumu", "anastomoz mukozası reepitelizasyon", "kas tabakasının tahribatı" "anastomoz hattında inflamatuar infiltrasyon" skorları incelendi ve kontrol grubu ile çalışma grubu arasında istatistiksel olarak anlamlı bir farklılık saptanmadı. Sonuç: Hem mekanik hem de histopatolojik değerlendirmelerde anlamlı farklılık bulunmaması nedeniyle; yeni tasarlanmış katlanabilir anvile sahip sirküler staplerin, standart sirküler staplerler ile aynı etkinlikte olduğunu ve rutin cerrahi ameliyatlarda kullanılması için daha fazla kontrollü deneysel çalışma yapılması gerektiğini düşünmekteyiz.
Aim: Although the use of staplers has been preferred in recent years, the disadvantages of existing staplers are damage due to their size, requiring additional suture in some operations, and not being able to place outside the abdomen in gastric and esophageal surgery. For these reasons, improvements have been made in the stapler mechanism. In this study, it was planned to investigate the effectiveness of the newly developed circular stapler with foldable anvil compared to the existing stapler. Materials and Methods: This study was obtained as a result of surgical interventions applied to 12 New Zealand albino species adult female rabbits bred in the laboratory of Selcuk University Experimental Medicine Research and Application Center. At the end of the surgical intervention, the anastomosis burst pressure was measured and recorded, and then tissue was removed from 3 cm around the anastomosis line. The obtained specimens were studied in the Medical Pathology laboratory of the Faculty of Medicine, Selcuk University. The findings were evaluated in IBM SPSS 22.0 program. Results: The rabbits were divided into two as the study group using circular stapler with foldable anvil and control group using standard circular stapler. Anastomosis burst pressure was evaluated, as one of the mechanical examination methods that evaluated the healing of the anastomosis line. Anastomosis burst pressures compared; no significant differences were found between the two groups. In histopathological evaluations, "presence of inflammatory granuloma and granulation tissue formation", "anastomosis mucosa reepithelization", "destruction of muscle layer", "inflammatory infiltration in the anastomosis line" scores were examined and no statistically significant difference was found between the control group and the study group. Conclusion: Due to the lack of significant differences in both mechanical and histopathological evaluations; We think that the newly developed circular stapler with foldable anvil is as effective as standard circular staplers and more controlled experimental studies are needed for its use in routine surgical operations.
Aim: Although the use of staplers has been preferred in recent years, the disadvantages of existing staplers are damage due to their size, requiring additional suture in some operations, and not being able to place outside the abdomen in gastric and esophageal surgery. For these reasons, improvements have been made in the stapler mechanism. In this study, it was planned to investigate the effectiveness of the newly developed circular stapler with foldable anvil compared to the existing stapler. Materials and Methods: This study was obtained as a result of surgical interventions applied to 12 New Zealand albino species adult female rabbits bred in the laboratory of Selcuk University Experimental Medicine Research and Application Center. At the end of the surgical intervention, the anastomosis burst pressure was measured and recorded, and then tissue was removed from 3 cm around the anastomosis line. The obtained specimens were studied in the Medical Pathology laboratory of the Faculty of Medicine, Selcuk University. The findings were evaluated in IBM SPSS 22.0 program. Results: The rabbits were divided into two as the study group using circular stapler with foldable anvil and control group using standard circular stapler. Anastomosis burst pressure was evaluated, as one of the mechanical examination methods that evaluated the healing of the anastomosis line. Anastomosis burst pressures compared; no significant differences were found between the two groups. In histopathological evaluations, "presence of inflammatory granuloma and granulation tissue formation", "anastomosis mucosa reepithelization", "destruction of muscle layer", "inflammatory infiltration in the anastomosis line" scores were examined and no statistically significant difference was found between the control group and the study group. Conclusion: Due to the lack of significant differences in both mechanical and histopathological evaluations; We think that the newly developed circular stapler with foldable anvil is as effective as standard circular staplers and more controlled experimental studies are needed for its use in routine surgical operations.
Açıklama
Anahtar Kelimeler
Cerrahi Stapler, Katlanabilir Anvil, Anastomoz, Sindirim Sistemi, Surgical Stapler, Foldable Anvil, Anastomosis, Digestive System
Kaynak
WoS Q Değeri
Scopus Q Değeri
Cilt
Sayı
Künye
Şener, S. (2022). Gastrointestinal sistemde uygulanan anastomozda katlanabilir stapler ile sirküler stapler etkinliğinin karşılaştırılması. (Uzmanlık Tezi). Selçuk Üniversitesi, Tıp Fakültesi, Konya.
