肠吻合采用不同缝线对克罗恩病术后复发的影响

目的探讨克罗恩病（CD）患者在肠切除吻合时使用不同缝线对CD术后复发的影响．方法回顾性分析2002年1月至2010年1月在南京军区南京总医院行肠切除肠吻合术的102例CD患者的临床资料,比较采用可吸收线（可吸收线组,48例）与丝线（丝线组,54例）进行缝合的患者术后内镜复发和临床复发情况。结果可吸收线组和丝线组术后1、2、3年累计临床复发率分别为6．3％、14．6％、22．9％和18．5％、27．8％、35．2％。差异无统计学意义（P=0．213）;两组术后1年和2年累计内镜复发率分别为14．7％、38．2％和22．9％、62．9％,差异有统计学意义（P=0．034）。结论CD患者在实施肠切除吻合术时采用可吸收线进行缝合相对于丝线能够显著降低CD术后内镜复发率;可吸收线可考虑作为CD肠吻合的首选缝合材料。

Absorbable suture delays postoperative recurrence after bowel resection for Crohn disease

Objective To investigate the effect of anastomosis suture on the postoperative recurrence in patients with Crohn disease (CD). Methods A total of 102 patients undergoing intestinal resection for CD at the Jinling Hospital of Nanjing University School of Medicine from Jan. 2002 to Jan.2010 were studied retrospectively. The postoperative recurrence (endoscopic and clinical) in patients receiving intestinal anastomosis with VICRYL absorbable suture (n=48) was compared with that of patients sewn with normal silk suture (n=54). Results The 1-, 2-, and 3-year accumulated clinical recurrence rates in the absorbable suture group and silk suture group were 6.3％, 14.6％, 22.9％, and 18.5％, 27.8％, 35.2％, respectively. The differences were not statistically significant (P=0.213). The 1- and 2-year accumulated endoscopic recurrence rates in the absorbable suture group and silk suture group were 14.7％, 38.2％ and 22.9％, 62.9％, respectively. The differences were statistically significant (P=0.034). Conclusions Compared to silk suture, use of absorbable suture for anastomosis may lower the risk of postoperative endoscopic recurrence after bowel resection in patients with CD. Absorbable suture should be the first choice for intestinal anastomosis in CD patients.