Ohira Gaku, Kawahira Hiroshi, Miyauchi Hideaki, Suzuki Kazufumi, Nishimori Takanori, Hanari Naoyuki, Mori Mikito, Tohma Takayuki, Gunji Hisashi, Horibe Daisuke, Narushima Kazuo, Matsubara Hisahiro
Department of Frontier Surgery Graduate School of Medicine, Chiba University, Chiba, Japan.
Surg Today. 2015 Jul;45(7):841-5. doi: 10.1007/s00595-014-1103-1. Epub 2015 Jan 6.
To compare the results of abdominal wall closure using interrupted synthetic short-term vs. long-term tensile strength-retaining absorbable sutures.
The subjects were 55 patients undergoing elective laparotomy through a midline vertical incision for gastric or colon cancer surgery between November 2008 and August 2010, at our hospital. After providing informed consent, the patients were randomized for suturing with Polysorb(®), which provides short-term tensile strength, or with PDS(®)II, which provides long-term strength. The primary outcome analyzed was the incidence of incisional hernia or wound dehiscence.
There were 28 patients allocated to the Polysorb group and 27 to the PDS II group. Postoperative wound dehiscence was noted in two patients (3.6%). Five of 51 patients (9.8%) suffered incisional hernia within 1 year after surgery, 6 of 41 patients (14.6%) within 2 years, and 6 of 35 patients (17.1%) within 3 years. There was no significant per year difference in the incidence of incisional hernia or wound dehiscence between the groups.
Outcomes were favorable in both groups and not inferior to reported outcomes of larger-scale studies. Verification of the equivalence between the two types of suture material necessitates larger-scale studies that adopt the same suture methods.
比较使用间断合成的短期与长期保留抗张强度的可吸收缝线进行腹壁缝合的结果。
研究对象为2008年11月至2010年8月期间在我院接受择期剖腹手术(通过正中垂直切口进行胃癌或结肠癌手术)的55例患者。在获得知情同意后,患者被随机分为使用提供短期抗张强度的聚乙醇酸缝线(Polysorb®)或提供长期抗张强度的聚对二氧环己酮缝线(PDS®II)进行缝合。分析的主要结局是切口疝或伤口裂开的发生率。
聚乙醇酸缝线组有28例患者,聚对二氧环己酮缝线II组有27例患者。2例患者(3.6%)出现术后伤口裂开。51例患者中有5例(9.8%)在术后1年内发生切口疝,41例患者中有6例(14.6%)在2年内发生,35例患者中有6例(17.1%)在3年内发生。两组之间切口疝或伤口裂开的发生率每年无显著差异。
两组的结局均良好,且不低于大规模研究报告的结局。验证两种缝线材料之间的等效性需要采用相同缝合方法的更大规模研究。