单向倒刺可吸收缝线在腹腔镜经腹腹膜前疝修补术中的应用

Application of unidirectional barbed suture in transabdominal preperitoneal prosthetic

目的探讨单向倒刺可吸收缝线在腹腔镜经腹腹膜前疝修补术(TAPP)中应用的安全性及有效性。方法回顾性分析2014年4月至2017年4月汕头大学医学院第二附属医院行TAPP患者67例,其中32例使用单向倒刺可吸收缝线缝合为倒刺线组,采用传统可吸收线缝合35例为传统缝线组,比较两组缝合时间、手术时间、术中出血、术后住院时间、术后并发症等情况。结果所有患者均成功手术,无中转开腹情况,术中未出现相关并发症。两组患者一般资料、术中出血量、术后并发症、术后住院时间差异均无统计学意义,而倒刺线组术中缝合时间(6.72±2.80)min、手术时间(63.00±5.44)min均短于传统缝线组的(15.04±1.19)min、(78.18±6.44)min,且两组间差异具有统计学意义(t=10.372,、15.572,均P<0.01)。所有患者出院后复查腹股沟区超声均未见复发,亦未诉特殊不适。结论单向倒刺可吸收缝线在TAPP中的应用安全、有效,可缩短腹膜缝合时间及手术用时间,降低术中腹腔镜下腹膜缝合难度,缩短手术学习曲线,值得在临床中广泛应用推广。

Objective To investigate the safety and effectiveness of unidirectional barbed suture in transabdominal preperitoneal prosthetic （TAPP）. Methods From April 2014 to April 2017, sixty-seven inguinal hernia patients were treated with TAPP in the Second Affiliated Hospital of Shantou University Medical College, with 32 undergoing inbarbed suture （inbarbed suture group）, and the other 35 patients with traditional suture （traditional suture group）. The suture time, operation time, intraoperative blood loss, hospital stay and complications of two groups were compared. Results All the 67 patients underwent operations successfully, with no one converting to open surgery and without perioperative complications. There were no statistical differences between the two groups in terms of preoperative general data, intraoperative blood loss, complications and hospital stay. The suture time and operation time of inbarbed suture group was （6.72±2.80） min and （63.00±5.44） min, which was significantly shorter than （15.04±1.19） min and （78.18±6.44） min of the traditional suture group, with statistically significant difference （t=10.372, 15.572, both P〈0.01）. All patients were under ultrasonic examination 1 to 3 months after discharging from hospital. No patient had recurrent inguinal hernia. Conclusion Unidirectional barbed suture can reduce the di？culty of laparoscopic suturing,and shorten the operation time and learning curve, which is worthy of clinical application in TAPP.