牙线牵引金属夹辅助缝合结直肠内镜黏膜下剥离术后大创面的临床应用

Clinical application of dental floss traction with metal clamp-assisted suture in large wound after colorectal endoscopic submucosal dissection

目的观察牙线牵引金属夹辅助缝合结直肠内镜黏膜下剥离术(ESD)后大创面的应用效果。方法行结直肠ESD患者40例,创面直径2.5~6.0cm,采用随机数字表法分为两组,每组20例。观察组使用牙线牵引金属夹辅助缝合结直肠ESD术后大创面,对照组使用传统金属夹缝合结直肠ESD术后大创面。比较两组患者围手术期相关指标和并发症发生情况。结果观察组创面完全闭合率(100%vs.90%)高于对照组,金属夹使用数量[(7.10±1.07)个vs.(8.55±2.06)个]和住院时间[(8.00±1.12)d vs.(9.85±1.98)d]少于对照组(P<0.05)。两组患者手术时间、创面直径、并发症发生率比较无统计学差异(P>0.05)。结论牙线牵引金属夹辅助缝合结直肠ESD术后大创面具有创面闭合率高和住院时间短的优点,不增加并发症发生率。

Objective To observe the application efficacy of dental floss traction with metal clamp-assisted suture in large wound after colorectal endoscopic submucosal dissection(ESD).Methods Forty patients underwent colorectal ESD,whose wound diameter was 2.5-6.0 cm.The patients were divided into two groups with 20 cases each.The dental floss traction with metal clamp was used to suture the large wound after colorectal ESD in group A,and traditional metal clamp was used to suture the large wound after colorectal ESD in group B.The relevant perioperative indexes and complications were compared between the two groups.Results Compared to group B,group A had higher wound closure rate(100%vs.90%),less number of metal clamp[(7.10±1.07)numbers vs.(8.55±2.06)numbers]and shorter hospital stay[(8.00±1.12)days vs.(9.85±1.98)days](P<0.05).There were no significant differences in the operation time,wound diameter and incidence of complications between the two groups(P>0.05).Conclusion Dental floss traction with metal clamp-assisted suture for large wound suture after colorectal ESD has the advantages of higher wound closure rate and shorter hospital stay without increasing the incidence of complications.