荷包缝合技术在早期消化道肿瘤ESD术后创面中的应用研究

Application of purse-string suture in wound surface after ESD for early gastrointestinal tumors

目的探讨荷包缝合技术在早期消化道肿瘤内镜黏膜下剥离术(ESD)术后创面中的应用效果。方法选取2018年2月至2020年12月该院行ESD治疗的72例早期消化道肿瘤患者,根据创面处理方式分为金属夹组(36例)和荷包缝合组(36例)。比较2组创面大小、操作成功率、耗材费用、操作时间、术后并发症、住院时间及金属夹滞留情况。结果2组创面长径、创面短径、操作成功率、耗材费用比较,差异有统计学意义(P<0.05)。金属夹组操作时间长于荷包缝合组,差异无统计学意义(P>0.05)。金属夹组发热、腹痛、迟发性穿孔发生率高于荷包缝合组,差异有统计学意义(P<0.05)。金属夹组住院时间为(7.25±2.47)d,长于荷包缝合组的(6.28±1.94)d,差异有统计学意义(P<0.05)。2组金属夹脱落情况比较,差异有统计学意义(P<0.05)。结论对于早期消化道肿瘤患者采用金属夹联合尼龙绳荷包缝合技术闭合ESD术后创面,具有操作成功率高、耗材费用低、创面缝合牢固、住院时间短、并发症少等优点,值得临床推广应用。

Objective To investigate the effect of purse-string suture in the wound surface after endoscopic submucosal dissection(ESD)of early gastrointestinal tumors.Methods 72 patients with early gastrointestinal tumors treated by ESD in the hospital from February 2018 to December 2020 were selected and divided into metal clip group(36 cases)and purse-string suture group(36 cases)according to the wound surface treatment method.The wound surface size,operation success rate,consumables cost,operation time,postoperative complications,hospital stay and retention of metal clip were compared between the two groups.Results There were significant differences in the long diameter and short diameter of wound surface,operation success rate and consumables cost between the two groups(P<0.05).The operation time of the metal clip group was longer than that of the purse-string suture group,and the difference was not statistically significant(P>0.05).The incidences of fever,abdominal pain and delayed perforation in the metal clip group were significantly higher than those in the purse string suture group(P<0.05).The hospital stay in the metal clip group was(7.25±2.47)d,which was longer than that in the purse suture group[(6.28±1.94)d],the difference was statistically significant(P<0.05).There was significant difference in the metal clip falling off between the two groups(P<0.05).Conclusion For patients with early gastrointestinal tumors,using metal clip combined with nylon rope purse-string suture to close the wound surface after ESD has the advantages of high operation success rate,low cost of consumables,firm wound surface suture,short hospital stay and less complications.It is worthy of clinical application.