30 cm与45 cm单向倒钩可吸收缝合线在腹腔镜袖状胃切除术中的应用比较

Comparison of 30cm and 45cm Barbed Unidirectional Sutures in Laparoscopic Sleeve Gastrectomy for Super Obesity

目的探讨30 cm和45 cm单向倒钩可吸收缝合线在腹腔镜袖状胃切除术中的应用效果。方法对2018年3月~2019年3月在中南大学湘雅二医院行腹腔镜袖状胃切除术的患者进行前瞻性研究,按照随机数字表法随机分为两组,每组34例。实验组采用30 cm单向倒钩可吸收缝合线缝合残胃,对照组采用45 cm单向倒钩可吸收缝合线缝合残胃。比较两组在缝合时间、所用缝线长度、术中及术后胃漏发生率、术后引流量和住院时间的差异。结果所有患者均成功完成手术,无中转开腹,围手术期无并发症发生。实验组与对照组比较,缝合时间及手术时间均较短(P<0.05),分别为(23.41±6.06)min VS(27.23±6.63)min和(116.70±28.00)min VS(131.15±30.18)min,术后引流量实验组更少(P<0.05),为(10.29±7.85)ml VS(18.53±19.72)ml。结论在腹腔镜下袖状胃切除术中,采用30 cm单向倒钩可吸收缝合线缝合残胃具有缝合时间短、手术及麻醉时间少、术后引流量少、腹腔镜下缝合难度低、学习曲线短等特点,值得临床推广。

Objective To compare postoperative results of 30cm and 45cm barbed unidirectional sutures during remnant stomach closure for patients undergoing a total laparoscopic sleeve gastrectomy(LSG)for super obesity.Methods A respective study was performed.There were 68 obese patients undergoing LSG from March 2018 to March 2019 enrolled into our study.They were divided into two groups randomly by Research Randomizer 2008,with 34 cases for each group.In the experimental group,the remnant stomach was closed with 30cm barbed unidirectional sutures and in the control group,they were sutured with 45cm ones.The differences of the two groups were compared in suture time,operation time,incidence of stomach leakage and the drainage amount after operation.Results All the patients were successfully operated without conversion to open surgery.In the experimental group and the the control group,suture time was(23.41±6.06)min VS(27.23±6.63)min and operation time was(116.70±28.00)min VS(131.15±30.18)min.The differences were significant(P<0.05).The postoperative drainage volume was(10.29±7.85)ml VS(18.53±19.72)ml,with significant difference(P<0.05).Conclusion It is safe and feasible to use 30cm sutures in laparoscopic sleeve gastrectomy.