Ureteral Repair with Titanium Staples: Comparison with Suture Closure - 08/09/11

Doi : 10.1016/S0090-4295(97)00694-8

Ari K Leppäniemi A, ^{^{1
The opinions expressed herein are those of the authors and are not to be construed as reflecting the views of the Uniformed Services University of the Health Sciences, the Department of the Army or the Department of Defence.}}⁎, ^{^{1
The opinions expressed herein are those of the authors and are not to be construed as reflecting the views of the Uniformed Services University of the Health Sciences, the Department of the Army or the Department of Defence.}}, David C Wherry A, ^{^{2
The opinions expressed herein are those of the authors and are not to be construed as reflecting the views of the Uniformed Services University of the Health Sciences, the Department of the Army or the Department of Defence.}}^{^{2
The opinions expressed herein are those of the authors and are not to be construed as reflecting the views of the Uniformed Services University of the Health Sciences, the Department of the Army or the Department of Defence.}}, Emmanouil Pikoulis A, ^{^{3
The opinions expressed herein are those of the authors and are not to be construed as reflecting the views of the Uniformed Services University of the Health Sciences, the Department of the Army or the Department of Defence.}}^{^{3
The opinions expressed herein are those of the authors and are not to be construed as reflecting the views of the Uniformed Services University of the Health Sciences, the Department of the Army or the Department of Defence.}}, Howard V Hufnagel A, ^{^{4
The opinions expressed herein are those of the authors and are not to be construed as reflecting the views of the Uniformed Services University of the Health Sciences, the Department of the Army or the Department of Defence.}}^{^{4
The opinions expressed herein are those of the authors and are not to be construed as reflecting the views of the Uniformed Services University of the Health Sciences, the Department of the Army or the Department of Defence.}}, Nancy Fishback B, ^{^{5
The opinions expressed herein are those of the authors and are not to be construed as reflecting the views of the Uniformed Services University of the Health Sciences, the Department of the Army or the Department of Defence.}}^{^{5
The opinions expressed herein are those of the authors and are not to be construed as reflecting the views of the Uniformed Services University of the Health Sciences, the Department of the Army or the Department of Defence.}}, Norman M Rich A, ^{^{6
The opinions expressed herein are those of the authors and are not to be construed as reflecting the views of the Uniformed Services University of the Health Sciences, the Department of the Army or the Department of Defence.}}^{^{6
The opinions expressed herein are those of the authors and are not to be construed as reflecting the views of the Uniformed Services University of the Health Sciences, the Department of the Army or the Department of Defence.}}
^A Department of Surgery , Uniformed Services University of the Health Sciences, Bethesda, Maryland USA
^B Department of Pathology, Uniformed Services University of the Health Sciences, Bethesda, Maryland USA

^*Ari Leppäniemi, M.D., Second Department of Surgery, Helsinki University Central Hospital, Haartmaninkatu 4, 00290 Helsinki, Finland

Abstract

Objectives. Vascular closure staple (VCS) clips made of titanium were initially developed for microvascular anastomoses with little knowledge of their effectiveness in larger tubular tissue structures. This study compares VCS clips and sutures in the closure of longitudinal ureterotomy incisions.

Methods. In 9 pigs, 1-cm-long anterior, longitudinal ureterotomy incisions were randomly assigned to closure with either 4-0 interrupted polyglactin sutures or VCS clips.

Results. Clip closure was significantly faster (74±28 versus 534±182 seconds). All 18 ureters were patent and without signs of leakage, calculus formation, or stenoses after 3 months. Clip closure resulted in slightly but not statistically significantly less narrowing of the duct lumen, but there was no difference in wall thickness at the repair site. At histologic examination, all 18 incisions healed without signs of acute inflammation or marked fibrosis.

Conclusions. Ureterotomy closure with VCS clips results in wound healing that is as effective as suture closure, with a comparable degree of narrowing. The time required for clip closure is only about 1/7 that required for suture closure.

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This study was supported by a grant from the U.S. Surgical Corporation, Norwalk, Connecticut.

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Vol 51 - N° 4

P. 553-557 - avril 1998 Retour au numéro

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Ureteral Repair with Titanium Staples: Comparison with Suture Closure - 08/09/11

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