应用一次性包皮环切缝合器与袖套式包皮环切术的临床疗效对比研究

目的:比较分析应用一次性包皮环切缝合器与袖套包皮环切术的临床疗效和手术并发症。方法:106例包皮过长(或包茎)患者按手术日期单双号分为一次性包皮环切缝合器组(50例)与袖套式包皮环切术组(56例)。比较两组患者的手术时间、术中出血量、术中疼痛程度、术后疼痛程度、切口愈合情况及术后并发症。结果:一次性包皮环切缝合器组与袖套式包皮环切术组手术时间分别为(31.38±2.93)min和(11.82±1.96)min;术中出血量分别为(1.14±0.94)ml和(7.89±2.31)ml;术中疼痛评分分别为(0.80±0.70)分和(3.02±1.22)分;术后24小时疼痛评分分别为(1.90±0.80)分和(4.45±1.03)分;术后并发症发生率分别为4.0%(2/50)和17.87%(10/56);切口愈合时间分别为(14.06±1.15)d和(14.39±1.57)d;外观满意率分别为98%(49/50)和83.93%(47/56)。与袖套式包皮环切组相比,一次性包皮环切缝合器组手术时间短、失血量少、术中及术后患者痛苦小、外观满意率高且并发症发生率低(P0.05),术后伤口愈合时间差异无统计学意义(P0.05)。结论:应用一次性包皮环切缝合器是对袖套式包皮环切术的改进及创新,具有患者手术效果好、并发症发生率低、患者满意度高及易于接受等优势。     

包皮环切缝合器手术与传统包皮环切术的临床对比分析

【摘要】目的观察包皮环切缝合器手术与传统包皮环切术的疗效对比。方法回顾性分析2015年7月至2016年7月间采取2种不同方法进行的包皮环切术共203例,其中传统手术114例,包皮环切缝合器手术89例,比较2种手术的手术时间,术中出血量,疼痛感,术后并发症发生情况,切口愈合时间及阴茎外形满意度。结果环切缝合器手术的手术时间,术中出血量,术中疼痛VAS,术后伤口愈合时间均明显小于传统手术（P<0.05）;阴茎外形满意度高于传统手术（P<0.05）;环切缝合器手术的术后出血、伤口感染及切口裂开等并发症发生率低于传统手术（P<0.05）;包皮水肿发生率2组无差异。结论环切缝合器在包皮环切术的应用,具有简便、快捷、微创、美容及并发症低的优点。     

人体组织黏合剂与传统缝合方法行包皮环切的疗效比较(附500例报告)

目的 对比研究人体组织黏合剂与传统缝合方法 对包皮环切切口的治疗效果.方法 门诊包皮环切手术1000例随机分成A、B两组,A组500例包皮切口应用人体组织黏合剂黏合,B组500例应用可吸收线或丝线间断缝合,观察闭合切口时间、切口疼痛率,术后水肿情况、切口愈合分级等指标.结果在关闭切口时间、切口疼痛率方面A组与B组差异有...     

一次性包皮切割缝合器与传统包皮环切术的应用比较

目的:比较一次性包皮切割缝合器行包皮环切术与传统包皮环切术的临床疗效。方法:214例患者分成两组,缝合器组108例,应用一次性包皮切割缝合器行包皮环切术;传统手术组106例,采用传统包皮环切手术。比较两种手术方式的手术时间、术中失血量、疼痛程度、术后相关并发症、术后性功能,并进行统计分析。结果:缝合器组在手术时间、术中失血量、术中和术后疼痛及术后并发症等方面,均明显优于传统手术组,差异有统计学意。并且缝合器组术后切口愈合好,外形美观,患者满意度较高。结论:一次性包皮切割缝合器是一种可靠的包皮环切新方法,值得临床推广。     

一次性包皮环切缝合器行包皮环切术的临床疗效观察

目的:观察使用一次性包皮环切缝合器治疗包茎和包皮过长的临床疗效及安全性。方法:将180例包茎和包皮过长患者随机分为缝合器组(包皮环切缝合器组,n=120)和传统组(背侧切开包皮环切手术组,n=60),观察两种包皮环切手术的出血量、手术时间、切口愈合时间、术后疼痛、水肿、切口美观度及术后并发症(瘀斑、血肿、感染及再手术率等)等指标。结果:缝合器组和传统组术中出血量分别为(2.3±1.3)ml和(15.6±2.9)ml;手术时间分别为(7.1±1.4)min和(22.6±4.6)min;切口愈合时间分别为(12.0±2.9)d和(16.3±3.1)d;术后24 h疼痛评分分别为(1.9±1.3)分和(5.2±1.7)分;水肿程度及切口美观度明显优于传统组(P0.05);缝合器组不存在拆线疼痛,传统组需要拆线存在拆线疼痛。结论:使用包皮环切缝合器完成包皮环切手术具有操作简单、手术快捷、切口美观、并发症少及痛苦小等优点。     

三种包皮环切术的临床应用比较

目的:比较包皮环切缝合器手术、包皮环切吻合器手术与传统包皮环切术治疗包皮过长或包茎患者的临床疗效。方法:回顾性分析我院泌尿外科门诊采用包皮环切缝合器手术(110例)、包皮环切吻合器手术(105例)、传统包皮环切术(520例)治疗包皮过长或包茎的735例患者的临床资料,比较三种术式的手术时间、术中出血量、术后并发症等指标。结果:包皮环切缝合器手术、包皮环切吻合器手术在手术时间和术中出血量等方面要优于传统包皮环切术(P0.05);且三种术式在手术并发症上的差异均有统计学意义(P0.05)。结论:三种术式各有优缺点,最后的术式选择需根据患者的病情、年龄、经济状况、对美观的要求和手术者对不同术式的手术技巧的熟悉程度等多方面来综合考虑决定。     

包皮过长的手术方式、经验和相关文献复习

目的总结一次性包皮环切缝合器、经典式及袖套式包皮环切术的经验,比较三种包皮环切术式的各自特点。方法回顾性分析于2014年7月至2016年7月期间在我院行包皮环切术(应用一次性包皮环切缝合器、经典式及袖套式包皮环切术分别为112例、123例及108例)患者的临床资料,比较三种术式手术时间、术中出血量、疼痛评分、术后并发症发生率、阴茎外观满意率等指标。分析三种手术各自特点和经验总结。结果应用一次性包皮环切缝合器、经典式及袖套式包皮环切术手术时间分别为5.6±3.5 min、25.6±6.7 min及34.3±5.4 min(P0.001),术中出血量分别为2.0±0.7 m L、12.3±5.8 m及4.1±2.3 m L(P0.001),术后24 h疼痛评分分别为3.1±1.1分、5.4±1.2分及3.5±0.9分(P0.001),术后并发症发生率分别为9.8%(11/112)、16.3%(20/123)及11.1%(12/108)(P=0.286),术后阴茎外观满意度分别为97.3%(109/112)、85.4%(105/123)及95.4%(103/108)(P=0.001)。以上数据比较,差异均有统计学意义。结论三组手术方式各有优缺点,应用一次性包皮环切缝合器操作简单、手术时间短、术中出血量少、术后阴茎外观满意率高,但费用偏高;而袖套式包皮环切术相对于经典式包皮环切术手术时间稍长,但术中出血量明显减少、术后疼痛评分低且阴茎外观满意度较高,因此,对于青春期男性及成人患者可考虑推荐袖套式包皮环切术。     

一次性包皮环切缝合器与传统包皮环切术的临床疗效对比分析

<正>包皮环切术是泌尿外科门诊手术室最常见的手术,目前我院主要开展三种包皮环切术,即传统包皮环切术、商环包皮环切术及一次性包皮环切缝合术,我们发现应用一次性包皮环切缝合器在手术时间、出血量、术后疼痛、并发症、愈合后的美观度、患者满意度方面比传统手术有着更加明显的优势。我们对预的约包皮过长、包茎患者285例患者进行分组治疗,依据患者自愿原则对其中的145例包皮过长或包茎患者行传统包皮     

4种包皮环切术临床疗效对比分析

正包皮环切术是泌尿外科最常见的手术~([1]),适用于病理性包茎,生理性包茎合并反复包皮阴茎头炎及尿路感染、包皮过长有手术要求等情况。目前临床术式众多,如背侧切开包皮环切术、袖套式包皮环切术、商环包皮环切术、缝合器包皮环切术等。本研究选取2012年1月至2016年12月在我院行包皮环切术854例成年患者的临床资料进行回顾性分析,通过比较4种手术方式的手术时间、术中出血     

单人操作单、双缝线打结定位切割平面行环切缝合器式包皮环切术的临床观察

目的:观察单人操作单、双缝线打结定位切割平面行环切缝合器式包皮环切术的临床疗效.方法:120例患者随机分配到传统环切缝合器组(组1)、单缝线打结定位环切器缝合器组(组2)、双缝线打结定位环切器缝合器组(组3)各40例.观察3组手术时间、术中出血量、系带处缝扎率、非系带处缝扎率、系带对合不良率、腹侧包皮预留满意率、背侧包...     

Basic interrupted versus continuous suturing techniques in bronchial anastomosis following sleeve lobectomy in dogs

Objective: Sleeve resection with or without lung resection is a valid conservative operation for patients with benign or malignant tumors; it enables the preservation of lung parenchyma. The aim of this prospective randomized study was to compare complications, operating time, and bronchial healing between the techniques of interrupted and continuous suturing for bronchial anastomosis in dogs. Methods: Twenty adult mongrel dogs each weighing 18–22 kg (average: 20 kg) were divided into two groups according to the anastomosis technique performed: group A, interrupted suturing and group B, continuous suturing. Each group comprised of 10 dogs. Following right thoracotomy, sleeve resection of the right cranial lobe was performed in all dogs. Basic interrupted sutures using 4/0 Vicryl (Ethicon, USA) were used in group A, and continuous sutures were used in group B. Results: The median anastomosis time was 15.2 min (range: 13–21 min) in group A and 9.6 min (range: 8–13 min) in group B. In all dogs, the anastomosis line was resected via right pneumonectomy for histopathological investigation 1 month after sleeve resection. Histopathological examination revealed that the healing of the anastomosis was not affected by the suturing technique applied. One dog from each group died on the fourth postoperative day; Fisher's exact test, p = 0.763. Conclusions: Our research revealed that the healing of the anastomosis was not affected by the suturing technique performed.     

The Rousso stitch: A new everting skin closure technique

The purpose of this article is to describe a new suturing technique that everts the skin and is a modification the horizontal mattress suture called the Rousso stitch. The technique is described step by step, along with reference pictures. The Rousso stitch technique was developed based on the well-documented theory behind everting the edges of thicker skin on closure of surgical incisions to allow for ideal coaptation and minimal scar formation. It is an easy technique to learn and appears to be a good time-saving option for the surgeon to use for the same applications of the typical horizontal mattress suture.     

输卵管问质部妊娠腹腔镜下病灶切开缝合与楔形切除的比较研究

目的探讨腹腔镜下输卵管间质部切开缝合术治疗输卯管间质部妊娠的临床应用价值。方法2007年1月～2012年6月,对间质部妊娠21例,根据患者的生育要求及术前血B—hCG情况选择手术方式。病灶楔形切除组9例,在腹腔镜下楔形切除病灶,可吸收线连续缝合切口;切开缝合组12例,在腹腔镜下切开病灶隆起部位,吸出孕囊及附属组织,可吸收线连续缝合切口。观察术中出血量及手术时间,术后B—hCG下降情况,术中亚甲蓝通液、术后碘油造影了解患侧输卵管通畅情况。结果2组手术时间、术中出血量、术前术后Hb差值差异均无显著性（P〉0．05）。2组术后第21—28天血B—hCG均降至正常．、切开缝合组患侧输卵管再通率术中为75％（9／12）,术后2个月为58％（7／12）。2组均无并发症发生。结论问质部妊娠行腹腔镜病灶切开缝合术可部分保留输卵管的通畅性。     

Laparoscopic repair of diaphragmatic defect by total intracorporeal suturing: clinical and technical considerations.

OBJECTIVE: The use of laparoscopy in urology is increasing. Tumor of the kidney or adrenal gland and, in some cases, metastatic disease can involve the diaphragm. We describe the application of laparoscopic suturing techniques in the case of diaphragmatic involvement with a renal tumor. METHODS: After resection of the tumor and a small area of the diaphragm, a chest tube was placed under laparoscopic guidance. The tube was kept clamped until the end of the procedure. Decreasing intraabdominal pneumoperitoneum pressure made suturing easier with less tension on the edges of the diaphragmatic incision. Nonabsorbable interrupted horizontal mattress sutures were placed to close the diaphragmatic defect. RESULTS: The repair was uneventful; no intraoperative complications occurred. Extubation was done at the end of the procedure in the operating room. The chest tube was removed on postoperative day 2, and the patient was discharged on postoperative day 3. CONCLUSIONS: Laparoscopic repair of the diaphragm should be commensurate with traditional open surgical principles. In this regard, it is essential that surgeons interested in performing "advanced" laparoscopic oncologic surgery become facile in laparoscopic suturing.     

Use of continuous horizontal mattress suture techniques in microsurgery: an experimental study in rats

PURPOSE: The purpose of this study was to determine whether the continuous horizontal mattress suture technique can replace the continuous simple suture technique and to compare the results with other microvascular suture procedures. METHODS: Sixty-four femoral arteries of 32 Sprague-Dawley rats were used in this study. The animals were divided equally into 4 groups with 16 anastomoses in each group. The arteries (0.8-1.0 mm diameter) were anastomosed by using the continuous horizontal mattress suture technique in group I, interrupted horizontal mattress suture technique in group II, simple interrupted suture technique in group III, and simple continuous suture technique in group IV. At the end of the anastomosis time, leakage, and patency were assessed and graded in all groups. On the 14th day after surgery the rats were killed and 5 patent specimens from each group were examined under light microscopy for histology. One specimen from each group was prepared for scanning of the endothelial surface under electron scanning microscopy. RESULTS: Group I anastomoses were performed the most quickly. Groups I and III anastomoses had 100% patency rates. Under light microscopy the edge eversion was apparent consistently and under electron microscopy all endothelial surfaces were intact and no suture material was seen in groups I and II. In group III some suture material was covered by endothelial cells and lumen surfaces were torn; endothelization also was rough compared with groups I and II. In group IV suture material was seen in the lumen because of a loose suture knot. The endothelium also was not regular. CONCLUSIONS: The horizontal mattress suturing technique is the only technique in which the suture material never contacts the lumen. Continuous horizontal mattress suture technique is superior to the other microvascular procedures and is the safest and fastest procedure for microvascular anastomosis in rats.     

Quill免打结缝合线与薇乔线在腹腔镜下胆总管连续缝合的应用比较

目的探讨Quill免打结缝合线在腹腔镜下胆总管连续缝合的应用效果。方法2011年3月～2013年6月79例腹腔镜胆总管探查术Quill免打结缝合线连续缝合胆总管作为Quill线组,同期72例薇乔线连续缝合胆总管作为薇乔线组,比较2组胆漏发生率、胆总管缝合时间、术后肠功能恢复、住院费用、住院时间等。结果Quill线组缝合时间（6．1±1．6）min,显著短于薇乔线组（14．2±2．5）min（t=23．923,P=0．000）;Quill线组住院时间（8．4±1．2）d,显著短于薇乔线组（11．5±3．2）d（t=8．016,P=0．000）;Quill线组术后胆漏发生率0,显著低于薇乔线组6．9％（5／72）（Fisher’s检验,P=0．023）。2组术后肠功能恢复时间、住院费用无统计学差异（P〉0．05）。结论腹腔镜胆总管探查术Quill线连续缝合可预防胆漏的发生,比薇乔线缝合更简单、快捷。     

甲板原位缝合结合皮内缝合法修复甲床挫裂伤

目的报道甲板原位缝合结合可拆线皮内缝合法修复甲床挫裂伤的临床疗效。方法对30例30指甲床挫裂患者,应用甲板原位缝合结合可拆线皮内缝合法进行修复,并对疗效进行分析。结果术后随访3～9个月,甲床伤口均一期愈合,再生甲板生长良好,根据甲床修复疗效评定标准评定：优24例24指占80％,良4例4指占13．3％,可2例2指占6．7％,优良率93．3％。结论应用甲板原位缝合结合可拆线皮内缝合法修复甲床挫裂伤,方法简单,疗效满意,是修复手指甲床损伤的理想方法。     

End-to-End Versus Augmented Repair in the Treatment of Acute Achilles Tendon Ruptures

We prospectively analyzed the functional and clinical results of patients who underwent a single end-to-end suture and an augmented tendon repair with plantaris tendon at middle-term follow-up. From January 2003 to May 2005, 30 consecutive patients were operated on for the treatment of acute Achilles' tendon rupture by means of 2 different methods. No cases required adjunctive procedures to allow for acceptable end-to-end apposition. All ruptures were acute and repairable. The patients were divided into 2 groups. In group 1, augmentation with plantaris tendon was performed in addition to the Krakow end-to-end suturing technique in 16 patients, and in group 2, only the Krakow end-to-end suturing technique was used in 14 patients. The average age of the patients was 40.6 years. Patients in the study groups were followed up at a mean of 17.8 months after surgery. At the end of the follow-up, functional and subjective outcome scores were evaluated. The American Orthopaedic Foot and Ankle Society hindfoot clinical outcome scores were 96.7 in group 1 and 98.8 in group 2. Although there was a numerical increase in group 2, no significant difference was determined between the 2 study groups statistically. The surgical outcome concerning local tenderness, skin adhesion scar, and tendon thickness was better in group 2 than in group 1 without a statistical significance. Although functional outcomes of both treatment groups were the same, the end-to-end suturing technique provided a safer and more reliable treatment with a low risk of complications in the treatment of acute Achilles' tendon ruptures compared with the plantaris tendon augmentation technique.     

Laparoscopic extra-abdominal suturing technique for the repair of Larrey’s diaphragmatic hernia using the port closure needle (Endo Close®): A case report

IntroductionMorgagni’s or Larrey’s diaphragmatic hernias are relatively uncommon. If the defect is too large for primary closure, the use of a mesh is inevitable. Although primary closure is adaptable for relatively small defects, it is difficult to suture the hernial orifice in which the anterior rim is absent. Herein, we present the case of a patient with Larrey’s diaphragmatic hernia that was easily and securely repaired using the recently developed laparoscopic extra-abdominal suturing technique via the port closure needle (Endo Close^®; Medtronic, Minneapolis, USA).Presentation of caseAn 89-year-old woman complaining of vomiting was transferred to our hospital. Computed tomography scan showed Larrey’s diaphragmatic hernia. Laparoscopic repair was performed after gastric decompression. We diagnosed Larrey’s hernia on the left side of the falciform ligament. The transverse colon was herniated through the defect. Since the hernial defect was located below the substernal space, there was no tissue to stitch at the anterior rim of the hernial orifice. We performed the extra-abdominal suturing technique, suturing the posterior rim of the hernia to the full thickness of the anterior abdominal wall using the port closure needle (Endo Close^®) without the need for a mesh. The patient was discharged on the 8th postoperative day. There was no evidence of recurrence at 8 months postoperatively.DiscussionThe recently developed extra-abdominal suturing technique using Endo Close^® to suture the full thickness of the anterior abdominal wall achieved secure mattress suture and easy extra-abdominal tying.ConclusionThis method may be useful in terms of easiness and security of suture.