单向倒刺可吸收缝线应用于腹腔镜肾部分切除术中的安全性及有效性研究

Safety and efficiency of unidirectional barbed suture for laparoscopic partial nephrectomy

目的了解单向倒刺可吸收缝线是否能有效应用于腹腔镜下肾部分切除术中肾脏的缝合操作。方法自2013年3月-2014年3月，共有27例肾脏肿瘤患者纳入本研究，均接受腹腔镜下’肾部分切除术。患者抽签分为两组，A组（n：12）在剜除肾脏肿瘤之后，采用普通抗菌涂层薇乔缝合集合系统及肾脏实质创面，B组（n=15）则使用单向倒刺可吸收缝合线（V-Loc180）缝合。采用t检验及Fisher精确检验对两组患者从一般人口学资料、肿瘤大小、热缺血时间、术中出血量以及手术时间等方面进行对比研究。结果A组患者12例，平均年龄62．0岁，肾脏肿瘤平均直径2．6cm，RENAL评分（6．3±0．8）分，热缺血时间28min，手术时间（137±20．2）min，1例术中中转开放，术中出血量（79．1±48．5）mL。B组患者15例，平均年龄61．3岁，肾脏肿瘤直径3．3cm，RENAL评分（6．5±0．5）分，热缺血时间（22．8±3．8）min，手术时间（120±15．7）min，2例因肿瘤较大腔镜下缝合困难中转开放。在肾脏热缺血时间方面，B组优于A组且差异具有统计学意义，其余各项指标两组间差异均未见统计学意义。结论V—Loe单向倒刺可吸收缝线可以安全有效用于腹腔镜下肾部分切除术，且能显著缩短术中。肾脏热缺血的时间，为临床推广使用提供了有效依据。

Objective To evaluate whether the unidirectional barbed suture is safety and efficiency enough for laparoscopic partial nephreetomy. Method From March 2013 to March 2014, 27 patients with renal mass have been involved into this study and divided into 2 groups wsing a lottery. Group A used Coated Vicryl in renorrhaphy after LPN, and group B used unidirectional barbed suture. All patients underwent LPN preformed by single group of surgeons. Perioperative and postoperative indicators were compared in two groups. Result It is identical in age, BMI, tumor size, R. E. N. A. L nephrometry scoring system between 2 groups. However, using barbed suture has significantly shortened in warm ischemia time （WIT）. The postoperative indicators, such as blood loss, hospital stay and surgery complication has no significantly difference in two groups. Conclusion The unidirectional barbed suture is safety and efficiency using in LPN which can shorten WIT significantly.