Schauer Ingrid, Theimer Oliver, Klatte Tobias, Waldert Matthias, Klingler Hans-Christoph, Margreiter Markus
Department of Urology, Kaiser-Franz-Josef-Hospital, Vienna, Austria.
Wien Klin Wochenschr. 2014 Jun;126(11-12):329-34. doi: 10.1007/s00508-014-0529-1. Epub 2014 Mar 21.
In the present study, we aimed to determine whether the use of self-retaining barbed sutures (SRBS) instead of conventional sutures during open partial nephrectomy leads to improved surgical outcomes.
PATIENTS, MATERIALS AND METHODS: A retrospective analysis of 50 consecutive patients who underwent open partial nephrectomy for a unicentric renal tumor was performed. In 15 patients, SRBS were used for parenchymal repair during open partial nephrectomy, and in 35 patients, conventional sutures were used. The parameters related to surgical outcomes were recorded and analysis of the total patient population and subgroup analysis according to the preoperative aspects and dimensions used for an anatomical (PADUA) score classification was performed.
The preoperative baseline values did not statistically differ between the groups. Analysis of the total patient population showed a significant difference regarding ischemia time (mean ± standard deviation) between the SRBS group (15.2 ± 6.9 min), and the conventional suture group (25.7 ± 11.8 min). There was no significant difference between the barbed and conventional sutures with regard to postoperative hemoglobin levels, decline in hemoglobin percentage, or renal function parameters. In subgroup-analysis, a significant difference in ischemia time was only found for PADUA scores 6 and 7, without any effect on the outcome parameters.
The use of SRBS in parenchymal repair during open partial nephrectomy appears to be a safe and feasible option with decreased cold ischemia time when compared with conventional sutures. In PADUA subgroup-analysis this difference was only observed for PADUA scores 6 and 7.
在本研究中，我们旨在确定在开放性部分肾切除术中使用自固定倒刺缝线（SRBS）而非传统缝线是否能改善手术效果。
患者、材料与方法：对50例因单中心肾肿瘤接受开放性部分肾切除术的连续患者进行回顾性分析。15例患者在开放性部分肾切除术中使用SRBS进行实质修复，35例患者使用传统缝线。记录与手术效果相关的参数，并对总体患者群体进行分析，同时根据术前用于解剖学（PADUA）评分分类的方面和尺寸进行亚组分析。
两组术前基线值在统计学上无差异。对总体患者群体的分析显示，SRBS组（15.2±6.9分钟）和传统缝线组（25.7±11.8分钟）之间的缺血时间存在显著差异。倒刺缝线和传统缝线在术后血红蛋白水平、血红蛋白百分比下降或肾功能参数方面无显著差异。在亚组分析中，仅在PADUA评分为6分和7分的患者中发现缺血时间存在显著差异，对结果参数无任何影响。
与传统缝线相比，在开放性部分肾切除术中使用SRBS进行实质修复似乎是一种安全可行的选择，可减少冷缺血时间。在PADUA亚组分析中，仅在PADUA评分为6分和7分的患者中观察到这种差异。
