比较可吸收缝线缝合与传统三层缝合对直肠癌腹会阴联合切除术后切口愈合质量的影响

Comparing absorbable suture and traditional three-layer suture on the quality of incision healing after abdominal perineal resection of rectal cancer

目的研究可吸收缝线缝合及传统三层缝合对直肠癌腹会阴联合切除术(APR)后切口愈合质量的影响。方法纳入2016年4月至2018年4月本院收治的90例直肠癌APR术患者作为研究对象,采用随机数字表分为观察组和对照组,每组45例。观察组术中采用聚对二氧环己酮Ⅱ(PDSⅡ)可吸收缝合线缝合,对照组采用普通丝线进行三层间断缝合。比较两组切口愈合率、术后切口愈合时间、创面肉芽组织情况以及切口并发症发生情况。结果观察组术后4 w切口愈合率与对照组比较,差异无统计学意义(P> 0.05),术后切口愈合时间短于对照组,差异有统计学意义(P <0.05)。观察组术后3 d和术后1 w时切口创面肉芽组织VEGF和EGF水平均高于对照组,肉芽组织评分低于对照组,差异均有统计学意义(均P <0.05)。观察组与对照组术后切口并发症总发生率分别为6.67%、17.78%,两组比较差异无统计学意义(P> 0.05)。结论 PDSⅡ可吸收缝线用于直肠癌APR术中切口缝合,有助于改善创面愈合情况及缩短术后切口愈合时间。

Objectives To compare absorbable suture and traditional three-layer suture on the quality of incision healing after abdominal perineal resection (APR) of rectal cancer. Methods 90 patients with rectal cancer treated in our hospital for APR from April 2016 and April 2018 were recruited and randomly assigned to treatment group and control group, with 45 patients in each group. Patients in treatment group received absorbable polydioxanone II (PDS II) suture during surgery and those in control group received three-layer discontinuous suture with ordinary silk thread. Rate of incision healing, time to incision healing, formation of granulation tissue and complications related to incision were compared between the two groups. Results There was no significant difference in the rate of incision healing at 4 weeks after surgery between treatment group and control group (P > 0.05). Time to incision healing was significantly shorter in treatment group than in control group (P < 0.05). Levels of VEGF and EGF of granulation tissue at 3 days and 1 week after operation was significantly higher, and scores of granulation tissue significantly lower in treatment group than in control group (P < 0.05). Incidence of complications related to incision was 6.67% and 17.78% in treatment group and control group, respectively, and there was no between-group difference (P > 0.05). Conclusion PDS II absorbable suture could be used in APR for rectal cancer for suture. It was beneficial for would healing and could shorten the time to healing.