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腹腔镜根治性前列腺切除术中使用聚乙醇酸(Monocryl®)和双向倒刺(V-Loc 180®)连续缝合进行尿道膀胱吻合术的比较。

Comparison of the urethrovesical anastomoses with polyglecaprone (Monocryl®) and bidirectional barbed (V-Loc 180®) running sutures in laparoscopic radical prostatectomy.

作者信息

Arslan Murat, Tuncel Altug, Aslan Yilmaz, Kozacioglu Zafer, Gunlusoy Bulent, Atan Ali

机构信息

Izmir University School of Medicine, Department of Urology, Izmir.

出版信息

Arch Ital Urol Androl. 2014 Jun 30;86(2):90-4. doi: 10.4081/aiua.2014.2.90.

DOI:10.4081/aiua.2014.2.90
PMID:25017586
Abstract

OBJECTIVE

We compared polyglecaprone (Monocryl®) and bidirectional barbed (V-Loc® 180) running sutures during urethrovesial anastomosis (UVA) in laparoscopic radical prostatectomy (LRP).

MATERIALS AND METHODS

A total of 92 consecutive patients underwent extraperitoneal LRP for prostate cancer. In the first 47 patients, the running UVA was performed using 3-0 monofilament polyglecaprone (Monocryl®) suture (Group 1). In the subsequent 45 patients, the running UVA was performed with the 3-0 barbed suture (V-Loc® 180) (Group 2). Rhabdosphincter reconstruction was performed in all the patients.

RESULTS

The mean prostatectomy time was 196 and 179 minutes in Group 1 and 2, respectively (p < 0.001). Moreover, the mean UVA time was 40 and 24 minutes in Group 1 and 2, respectively (p < 0.001). Also, catheterization time, lenght of hospital stay and the number of the patients with urine leakage were significantly lower in Group 2 than the other (p < 0.001). No patients in V-Loc® 180 suture group and 5 patients in Monocryl® suture group experienced postoperative drain leakage in the present study. Overall pad usage at 6th month was higher in group 1 than the other group. In group 1 and 2, 78.7% and 93.3% of the patients reported 0 to 1 pads daily, whereas 21.3% and 6.7% reported ≥ 2 pads daily (p = 0.002).

CONCLUSIONS

We therefore consider that use of barbed suture running UVA during LRP is associated with a significantly shorter operative time maintaining a proper suturing tension compared with standard suture and it is not associated with a higher incidence of adverse events with no postoperative complications.

摘要

目的

我们在腹腔镜前列腺癌根治术(LRP)的尿道膀胱吻合术(UVA)过程中比较了聚乙醇酸(Monocryl®)和双向倒刺(V-Loc® 180)连续缝合线。

材料与方法

共有92例连续的前列腺癌患者接受了腹膜外LRP。前47例患者使用3-0单丝聚乙醇酸(Monocryl®)缝线进行连续UVA(第1组)。在随后的45例患者中,使用3-0倒刺缝线(V-Loc® 180)进行连续UVA(第2组)。所有患者均进行了横纹括约肌重建。

结果

第1组和第2组的平均前列腺切除时间分别为196分钟和179分钟(p<0.001)。此外,第1组和第2组的平均UVA时间分别为40分钟和24分钟(p<0.001)。而且,第2组的导尿时间、住院时间和尿漏患者数量均显著低于另一组(p<0.001)。在本研究中,V-Loc® 180缝线组无患者发生术后引流管漏,而Monocryl®缝线组有5例患者发生。第1组第6个月时的总体尿垫使用量高于另一组。在第1组和第2组中,分别有78.7%和93.3%的患者报告每天使用0至1个尿垫,而分别有21.3%和6.7%的患者报告每天使用≥2个尿垫(p = 0.002)。

结论

因此,我们认为在LRP期间使用倒刺缝线进行连续UVA与标准缝线相比,手术时间显著缩短,同时能保持适当的缝合张力,且与较高的不良事件发生率无关,无术后并发症。

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