Quill线在腹腔镜肾盂输尿管成形术中应用

Application of Quill Suture Line in Retroperitoneoscopic Pyeloureteroplasty

目的探讨Quill线(双向倒刺可吸收线)在腹腔镜肾盂输尿管成形术的可行性。方法2011年3月至2013年9月,本院共实施39例腹腔镜肾盂输尿管成形术,其中采用普通5-0可吸收线行成形缝合术21例(A组),18例采用Quill线缝合(B组)。A组男12例,女9例,年龄6~18岁,平均年龄14.6岁;B组男11例,女7例。年龄7~33岁,平均16.6岁。所有患者均经B超、CTU或磁共振成像检查确诊为肾盂输尿管交界处狭窄。结果 39例腹腔镜肾盂输尿管成形手术全部顺利完成。A组手术时间(79.5±21.4)分钟。术中出血量(18.5±21.2)ml;B组手术时间(60.8±13.3)分钟。术中出血量(20.3±22.4)ml;术中均未输血。A组肾盂成形缝合时间(22.4±3.2)分钟;B组肾盂成形缝合时间(10.4±2.6)分钟。术后住院两组均在5~7天,平均6天。随访时间1~31个月,两组病人随访B超复查均无再发狭窄病例,无缝线结石生成病例。结论 Quill线在腹腔镜肾盂输尿管成形术中应用能够明显缩短缝合时间,具有很好的安全性和可行性。

Objective To investigate the feasibility of Quill suture line application in retroperitoneoscopic py-eloureteroplasty.Methods Between Mar 2011 and Sep 2013, 39 cases of retroperitoneoscopic pyeloureteroplasty was performed in our hospital , 5-0 adsorbable line was used in 21 cases ( A group ) , bidirectional barbed ab-sorbable suture line was used in 18 cases(B group), With 12 males and 9 females in group A, age 6~18years;mean 14.6 years.In group B, with 11 males and 7 females, age 7~33years;mean 16.6 years.All cases were diagnosed for ureteropelvic junction stricture by B -ultrasonic, CTU or MRU.Results All 39 cases of retroper-itoneoscopic pyeloureteroplasty were successfully performed , without conversion to open surgery and important in-traoperative complications .In group A, the operative time was ( 79.5 ±21.4 ) min, the blood loss was 18.5 ±21.2ml, suture time was 22.4 ±3.2min, In group B,the operative time was 60.8 ±13.3min, the blood loss was 20.3 ±22.4ml, suture time was 10.4 ±2.6min, without operative blood transfusion , In two groups , hospital stay was 5~7 d, mean 6 d.The follow up time was 1~31 months, the case with stenosis of ureter was not found any more , and the Sutures Calculi was not appeared also .Conclusions The application of Quill suture line in retroperitoneoscopic pyeloureteroplasty could shorten suture time , with good safety and feasibility , worthy of being applicated generally in clinic .