倒刺缝线在腹腔镜胃十二指肠溃疡穿孔修补术中的应用

目的探讨单向倒刺缝线在腹腔镜胃十二指肠溃疡穿孔修补术中应用的安全性及有效性。方法将2014年6月至2016年6月期间60例行腹腔镜胃十二指肠溃疡穿孔修补术的患者分为两组,其中32例采用传统可吸收线缝合为传统缝线组,28例采用倒刺线缝合为倒刺线组,采用SPSS 17.0统计软件分析两组资料,缝合时间、手术时间、术中出血、术后住院时间采用均数±标准差表示,采用t检验;术后并发症计数资料采用χ~2检验;P0.05为差异具有统计学意义。结果所有患者均成功完成手术,无中转开腹,围手术期无并发症发生。两组患者术前一般资料、术中出血、术后住院时间差异均无统计学意义(均P0.05),但倒刺线组缝合时间(6.4±2.8)min比(41.8±6.5)min]、手术时间(18.6±4.5)min比(65.8±8.3)min]均明显少于传统缝线组(均P0.05)。60例均获得随访。随访时间3~22个月,平均随访11.5个月。所有患者出院1~3个月返院行胃镜检查,无幽门狭窄、溃疡出血等。结论倒刺缝线在腹腔镜胃十二指肠溃疡穿孔修补术的应用是安全有效,能够缩短缝合时间及手术时间,降低腹腔镜下缝合难度,缩短学习曲线,值得在临床上广泛应用。

Application of unidirectional barbed suture in laparoscopic repair of gastroduodenal ulcer perforation

Objective To investigate the safety and effectiveness of laparoscopic repair of gastroduodenal ulcer perforation by using unidirectional barbed suture.Methods Sixty patients undergoing laparoscopic repair of gastroduodenal ulcer perforation from June 2014 to June 2016,were randomly divided into two groups,including 32 cases in traditional suture group and in 28 cases in barbed suture group.Statistical analyses were performed by using SPSS version 17.0 software.The measurement data such as Suture time,operation time,intraoperative blood loss and hospital stay were expressed as ((x) ± s),and were examined by using t test.Count data such as complication rate were examined by using x2 test,A P value ＜ 0.05 was considered as statistically significant difference.Results All of 60 patients underwent successful operations without conversion to open surgery and without perioperative complications.There were no statistical difference between the two groups in terms of preoperative general data,intraoperative blood loss,and hospitalization time (P ＞ 0.05).Compared with traditional suture group,both suture time and operation time were shorter.in unidirectional barbed suture group (6.4 ± 2.8) min vs (41.8 ±6.5) min and (18.6 ±4.5) min vs (65.8 ±8.3) min respectively (P＜0.05).All patients were followed up for 3 to 22 months(averaged 11.5months).All of patients were examined by gastroscopy 1 to 3 months after discharging from hospital.No patient had complications related to pyloric stenosis,ulcer bleeding and so on.Conclusion It is safe and feasible to perform laparoscopic repair of gastroduodenal ulcer perforation by using unidirectional barbed suture,which could reduce the difficulty of laparoscopic suturing,and shorten the operation time and learning curve.It is worthy of wider application in clinic.