Einarsson Jon I, Vellinga Thomas T, Twijnstra Andries R, Chavan Niraj R, Suzuki Yoko, Greenberg James A
Brigham and Women's Hospital, 75 Francis St, ASB 1-3, Boston, MA 02118, USA.
JSLS. 2010 Jul-Sep;14(3):381-5. doi: 10.4293/108680810X12924466007566.
To evaluate the safety and efficacy of using bidirectional barbed suture in laparoscopic myomectomy (LM) and total laparoscopic hysterectomy (TLH).
This was a case series of clinical outcomes following 172 consecutive LM and TLH cases over a 1-year period conducted at a university teaching hospital. It included 172 women (ages 17 to 81), requiring a myomectomy or hysterectomy for symptomatic uterine fibroids, pelvic pain, or abnormal uterine bleeding; 117 women underwent TLH and 55 women underwent LM. Patients were contacted over the phone 6 months after surgery to inquire about number of days of postoperative vaginal bleeding, visits to the hospital due to bleeding, dyspareunia, and other potential complications.
For TLH, the average duration of surgery was 109 minutes, average uterine weight was 256 grams (range, 18 to 1242), and average blood loss was 71 mL. In LM, average duration of surgery was 125 minutes, average weight of fibroids was 252 g, average number of fibroids removed was 4.0, and average blood loss was 159 mL. Seven percent of patients and 8% of their partners had persistent dyspareunia after surgery. There were no conversions to laparotomy.
The use of bidirectional barbed suture appears to be safe for closing the vaginal cuff in a TLH and for closing the hysterotomy site during a laparoscopic myomectomy.
评估双向倒刺缝线在腹腔镜子宫肌瘤切除术（LM）和全腹腔镜子宫切除术（TLH）中的安全性和有效性。
这是一项病例系列研究，对一所大学教学医院在1年时间内连续进行的172例LM和TLH病例的临床结果进行分析。研究纳入了172名女性（年龄17至81岁），她们因有症状的子宫肌瘤、盆腔疼痛或异常子宫出血而需要进行子宫肌瘤切除术或子宫切除术；其中117名女性接受了TLH，55名女性接受了LM。术后6个月通过电话联系患者，询问术后阴道出血天数、因出血到医院就诊情况、性交困难及其他潜在并发症。
对于TLH，平均手术时长为109分钟，平均子宫重量为256克（范围18至1242克），平均失血量为71毫升。在LM中，平均手术时长为125分钟，平均肌瘤重量为252克，平均切除肌瘤数量为4.0个，平均失血量为159毫升。7%的患者及其伴侣在术后有持续性性交困难。无一例转为开腹手术。
双向倒刺缝线用于TLH中关闭阴道断端以及LM中关闭子宫切口似乎是安全的。
