“十字”缝合法在腹腔镜APR会阴部切口重建中的应用

Application of"Cross"Suturing Method in Laparoscopic APR Perineal Incision Reconstruction

目的:探讨“十字”缝合法在腹腔镜腹会阴联合切除术(abdominoperineal resection,APR)会阴部切口重建中的应用。方法:选取2017年1月—2022年12月钦州市第一人民医院胃肠外科收治的60例低位直肠癌患者。随机将其分为试验组和对照组,各30例。两组均给予腹腔镜APR,试验组腹腔镜APR会阴部切口重建应用“十字”缝合法,对照组腹腔镜APR会阴部切口重建应用常规间断缝合法。比较两组围手术期指标,术后7 d切口愈合情况,并发症。结果:试验组手术时间、住院时间均短于对照组,术中出血量及引流量均少于对照组,正常饮食时间、腹腔引流管拔管时间均早于对照组,差异有统计学意义(P<0.05)。试验组切口愈合情况优于对照组,差异有统计学意义(P<0.05)。试验组并发症发生率低于对照组,差异有统计学意义(P<0.05)。结论:“十字”缝合法用于腹腔镜APR会阴部切口重建,能够降低切口张力,促进伤口愈合,住院时间短。

Objective:To explore the application of"cross"suturing method in laparoscopic abdominoperineal resection(APR)perineal incision reconstruction.Method:A total of 60 patients with low rectal cancer admitted to the Department of Gastrointestinal Surgery of Qinzhou First People's Hospital from January 2017 to December 2022 were selected.They were randomly divided into experimental group and control group,30 cases in each group.Both groups were given laparoscopic APR,and the experimental group applied"cross"suture method for perineal incision reconstruction in laparoscopic APR,the control group applied conventional interrupted suture method for perineal incision reconstruction in laparoscopic APR.Perioperative indexes,wound healing condition 7 d after operation and complications were compared between the two groups.Result:The operation time and hospital stay of the experimental group were shorter than those of the control group,the intraoperative blood loss volume and drainage volume were less than those of the control group,the normal diet time and the time of abdominal drainage tube extraction were earlier than those of the control group,the differences were statistically significant(P<0.05).The wound healing condition of experimental group was better than that of control group,and the difference was statistically significant(P<0.05).The incidence of complication of experimental group was lower than that of control group,and the difference was statistically significant(P<0.05).Conclusion:The"cross"suture method for laparoscopic APR perineal incision reconstruction can reduce incision tension,promote wound healing,and shorten hospital stay.