Ardovino Mario, Castaldi Maria Antonietta, Fraternali Fernando, Ardovino Italo, Colacurci Nicola, Signoriello Giuseppe, Cobellis Luigi
1 Department of the Woman, the Child and General and Specialized Surgery, Second University of Naples , Naples, Italy .
J Laparoendosc Adv Surg Tech A. 2013 Dec;23(12):1006-10. doi: 10.1089/lap.2013.0103.
To compare bidirectional knotless barbed suture versus standard sutures, with either extracorporeal or intracorporeal knots, and to assess the feasibility, safety, and rapidity in repairing a uterine wall defect after laparoscopic myomectomy.
This was a randomized clinical study having a Canadian Task Force Classification of I. In tertiary-care university-based teaching hospitals, 117 women who underwent laparoscopic myomectomy were enrolled. In accord with randomization, uterine wall defects were closed with either extracorporeal (poliglecaprone 25; Monocryl™-1; Ethicon Inc., Somerville, NJ) or intracorporeal (polyglactin 910; Vicryl™-1; Ethicon Inc.) knots or a bidirectional knotless barbed suture (Quill™-0; Angiotech Pharmaceuticals, Inc., Vancouver, BC, Canada).
Time required to suture was significantly lower in the group operated on with a bidirectional suture than in groups with traditional sutures (P<.001). No significant difference was observed in operative time among the study groups. The degree of surgical difficulty was significantly lower in the Quill group than in the other groups.
Use of barbed sutures reduces the time required to repair a uterine wall defect during laparoscopic myomectomy. In a follow-up of patients carried out at 3 months, 6 months, and 1 year after the surgery, there were no wound dehiscence, no bleeding, and no other potential major complications.
比较双向无结倒刺缝线与标准缝线（体外或体内打结），并评估腹腔镜子宫肌瘤切除术后修复子宫壁缺损的可行性、安全性和速度。
这是一项加拿大工作组分类为I级的随机临床研究。在以大学为基础的三级护理教学医院中，纳入了117例行腹腔镜子宫肌瘤切除术的女性。根据随机分组，子宫壁缺损分别采用体外（聚乙醇酸25；爱惜康公司生产的慕思可™-1，新泽西州萨默维尔）或体内（聚乳酸910；爱惜康公司生产的薇乔™-1）打结或双向无结倒刺缝线（加拿大不列颠哥伦比亚省温哥华的安进制药公司生产的奎尔™-0）进行缝合。
双向缝线组的缝合时间明显低于传统缝线组（P<0.001）。各研究组的手术时间无显著差异。奎尔组的手术难度明显低于其他组。
使用倒刺缝线可减少腹腔镜子宫肌瘤切除术中修复子宫壁缺损所需的时间。在术后3个月、6个月和1年对患者进行的随访中，未出现伤口裂开、出血及其他潜在的重大并发症。
