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V-Loc 缝合关闭装置在胃肠缝合中的应用:初步研究。

The application of the V-Loc closure device for gastrointestinal sutures: a preliminary study.

机构信息

Department for Orthopaedics and Orthopaedic Surgery, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria,

出版信息

Surg Endosc. 2013 Oct;27(10):3830-4. doi: 10.1007/s00464-013-2982-8. Epub 2013 May 4.

Abstract

BACKGROUND

Leakage is one of the major complications in gastrointestinal surgery. This preliminary study compared a new barbed absorbable thread for gastrointestinal sutures with monofil suture material in a cadaver model.

METHODS

In this study, mechanical experiments were performed in 20 recently deceased individuals. Incisions were made in the small intestine, colon, and stomach, and then sutures were created with the V-Loc closure device and monofil suture material. Intestinal bursting pressure was measured by inserting a balloon and slowly filling it with air until there was a dehiscence, or wall or suture rupture.

RESULTS

The bursting pressures differed significantly between the two sutures in the small intestine, showing the advantage of the V-Loc closure device, which had a mean bursting pressure of 116.2 mmHg compared with 110 mmHg for the monofil suture (p = 0.003). The mean bursting pressure did not differ significantly between the two sutures in the colon and the stomach. The mean bursting pressures for the V-Loc closure device were 141.3 mmHg (stomach) and 137.2 mmHg (colon) compared with the monofil suture material bursting pressures of 133 mmHg (stomach) and 134.8 mmHg (colon).

CONCLUSIONS

Because the bursting strength of the sutures created with monofil suture material differs significantly from that of the V-Loc closure device, the V-Loc suture material should be used for gastrointestinal sutures. Although the two sutures did not differ significantly in the colon or the stomach, the V-Loc closure device should be used for these as well because its advantages may overrule those of the monofil suture. No knot tying is required, and the operating time can be shorter. Especially for laparoscopic surgery, the V-Loc closure device is recommended.

摘要

背景

渗漏是胃肠外科的主要并发症之一。本初步研究比较了一种新型的带倒刺可吸收缝线与单丝缝线材料在尸体模型中的效果。

方法

本研究在 20 名最近死亡的个体中进行了力学实验。在小肠、结肠和胃上切开切口,然后使用 V-Loc 闭合装置和单丝缝线材料进行缝合。通过插入一个气球并缓慢向其中充气直至发生破裂,即壁或缝线破裂,来测量肠破裂压。

结果

两种缝线在小肠中的破裂压力差异显著,V-Loc 闭合装置具有优势,其平均破裂压力为 116.2mmHg,而单丝缝线为 110mmHg(p=0.003)。两种缝线在结肠和胃中的平均破裂压力无显著差异。V-Loc 闭合装置的平均破裂压力分别为 141.3mmHg(胃)和 137.2mmHg(结肠),而单丝缝线材料的破裂压力分别为 133mmHg(胃)和 134.8mmHg(结肠)。

结论

由于单丝缝线材料所形成的缝线的抗张强度与 V-Loc 闭合装置有显著差异,因此应使用 V-Loc 缝线进行胃肠缝合。尽管两种缝线在结肠或胃中没有显著差异,但也应使用 V-Loc 闭合装置,因为其优势可能超过单丝缝线。不需要打结,操作时间可以更短。特别是对于腹腔镜手术,推荐使用 V-Loc 闭合装置。

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