Novel Asymmetrical Linear Stapler: Safety Test and Pathological Assessment in a Porcine Model.

Autor: Jung YC; Department of Thoracic and Cardiovascular Surgery, Chungnam National University Hospital, Chungnam National University School of Medicine, Daejeon, South Korea., Piao WX; Department of Thoracic and Cardiovascular Surgery, Chungnam National University Hospital, Chungnam National University School of Medicine, Daejeon, South Korea., Kim JY; Department of Surgery, Chungnam National University Hospital, Chungnam National University School of Medicine, Daejeon, South Korea., Lee SI; Department of Surgery, Chungnam National University Hospital, Chungnam National University School of Medicine, Daejeon, South Korea., Cui YJ; Department of Thoracic and Cardiovascular Surgery, Chungnam National University Hospital, Chungnam National University School of Medicine, Daejeon, South Korea., Chong Y; Department of Thoracic and Cardiovascular Surgery, Chungnam National University Hospital, Chungnam National University School of Medicine, Daejeon, South Korea., Cho HJ; Department of Thoracic and Cardiovascular Surgery, Chungnam National University Sejong Hospital, Sejong-si, South Korea. Electronic address: irainy79@naver.com., Kang MW; Department of Thoracic and Cardiovascular Surgery, Chungnam National University Hospital, Chungnam National University School of Medicine, Daejeon, South Korea. Electronic address: dreamerkang@hanmail.net.
Jazyk: angličtina
Zdroj: The Journal of surgical research [J Surg Res] 2024 Dec; Vol. 304, pp. 58-66. Date of Electronic Publication: 2024 Nov 09.
DOI: 10.1016/j.jss.2024.10.003
Abstrakt: Introduction: Prognosis in patients undergoing resection for lung and gastrointestinal cancers may differ, depending on the microscopic involvement of surgical margins. Linear staplers, widely used for pulmonary or bowel resection, consist of three rows of fasteners on both sides of a resection line. Although multiple rows of fasteners ensure stump and specimen closure, specimen could compromise accurate pathological evaluation of the true surgical margin. We aimed to compare the novel asymmetrical linear stapler (NALS) with the symmetrical linear stapler (SLS) in a porcine model for stump security and accurate pathological evaluation.
Materials and Methods: We used the NALS with three and two rows of staples on the stump and specimen sides, respectively. We performed small bowel resection in a porcine model using the NALS and examined hemostasis of resection margin, tightness of stumps under a specific burst pressure, distances between the true resection margin and staple line, and pathology of the resection margin. An SLS was used as the control.
Results: No bleeding was observed at the tissue site after initial blotting of the stapler line with either stapler type. The staplers endured a burst pressure of 3.6 kPa for 15 s without leakage. The distance between the cutting edge and staple line for two rows was significantly greater than the distance between the cutting edge and the nearest staple line for three rows.
Conclusions: The NALS is safe and may be more accurate than is SLS for the pathological evaluation of true surgical margins.
(Copyright © 2024 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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