V-Loc^(TM)单向倒刺缝线与薇乔缝线在后腹腔镜下肾部分切除术中的应用比较

V-Loc^(TM) self-retaining barbed suture vs.Vicryl^(TM) polyglactin suture for renorrhaphy in retroperitoneal laparoscopic partial nephrectomy for patients with renal cell carcinoma

目的回顾性分析并比较新型可吸收单向倒刺缝线(V-Loc^(TM))与传统可吸收薇乔缝线(Vicryl^(TM))在后腹腔镜肾癌肾部分切除术中的安全性及肾脏创缘的缝合效率。方法对2014年1月至2014年12月在西安交通大学第一附属医院泌尿外科就诊,并行后腹腔镜下肾部分切除术的60例肾癌患者的临床资料进行回顾性分析,其中30例患者采用V-Loc^(TM)180缝线(美国Covidien公司)缝合肾脏创缘,另外30例患者采用Vicryl^(TM)缝线(上海强生公司)缝合肾脏创缘。比较使用上述不同缝线的两组患者在人口学数据及围手术期临床数据方面的差异。结果两组患者的基线人口学数据,包括年龄、体重指数、肿瘤直径、术前影像学R.E.N.A.L.评分无统计学差异;两组患者的手术时间、术中出血量、输血率、并发症发生率、术后引流量、术后住院时间均无显著统计学差异。但使用V-Loc^(TM)缝线组患者的术中平均热缺血时间[(18.2±1.5)vs.(24.7±1.2)min,P=0.047]显著短于使用Vicryl^(TM)缝线组,两者之间具有统计学差异。结论这种新型V-Loc^(TM)倒刺缝线线可安全、有效地被用于后腹腔镜肾癌肾部分切除术,与传统的薇乔缝线相比,可显著缩短术中肾脏热缺血时间。

Objective To evaluate the safety and efficacy of the novel self-retaining barbed suture（V-Loc^（TM））for renorrhaphy in retroperitoneal laparoscopic partial nephrectomy（RLPN）for patients with renal cell carcinoma in comparison with conventional absorbable polyglactin suture（Vicryl^（TM））.Methods Clinical data of 60 patients with renal cell carcinoma who received RLPN during Jan.2014 and Dec.2014 in our institution were retrospectively reviewed.Of all patients,30 received renorrhaphy with V-Loc^（TM）180 suture（Covidien,Mansfield,MA）,and the other 30 underwent Ethicon absorbable Vicryl^（TM） polyglactin suture（Johnson Johnson,Shanghai,China）.Demographic and perioperative data were retrospectively compared between patients with the two different types of suture materials.Results Baseline demographic characteristics including age,body mass index,tumor size,and R.E.N.A.L.nephrometry score were identical between the two groups.Additionally,there were no significant differences between the two groups with regard to operative time,estimated blood loss,transfusion,surgical complications,volume of postoperative drainage and length of postoperative hospital stay.However,the mean warm ischemia time（WIT）was significantly shorter in the V-Loc^（TM）group compared with that in the Vicryl^（TM）group[（18.2±1.5）vs.（24.7±1.2）min,P=0.047].Conclusions Use of V-Loc^（TM）suture for renorrhaphy during RLPN for patients with renal cell carcinoma is safe and feasible and significantly reduces WIT compared with conventional absorbable Vicryl^（TM）polyglactin suture.