Department of Surgery, Gyeongsang National University Hospital, Gyeongsang National University Postgraduate School of Medicine, 79 Gangnam-ro, Jinju, 52727, Republic of Korea.
Surg Endosc. 2018 Aug;32(8):3667-3674. doi: 10.1007/s00464-018-6099-y. Epub 2018 Feb 22.
Laparoscopic primary repair is one of the main procedures used for perforated gastric ulcers, and this technique requires reproducible and secure suturing. The aim of this study was to investigate the safety and efficacy of a novel continuous suture method with barbed sutures during laparoscopic repair for perforated peptic ulcers.
Clinical data from 116 consecutive patients undergoing laparoscopic repair for perforated peptic ulcers were collected between November 2009 and October 2015. Continuous suturing with 15-cm-long unidirectional absorbable barbed sutures was used for laparoscopic repair in the study group, termed group V (n = 51). Patients who underwent laparoscopic repair with conventional interrupted sutures were defined as group C (n = 65). The complication and operative data were compared between groups.
Although there was no difference between group V and group C in the overall complication rate (15.7% vs. 24.6%; p = 0.259), the complication rate related to suturing was lower (3.9% vs. 15.4%; p = 0.04) in group V. Group V showed rates of 0% for leakage, 2% for intra-abdominal fluid collection, and 2% for stricture; the corresponding rates in group C were 3.1, 7.7, and 4.6%, respectively. Regarding operative data, the total operation time (V vs. C, 87.7 min vs. 131.2 min), total suture time (7.1 min vs. 25.3 min), and suture time per stitch (1.2 min vs. 6.2 min) were significantly shorter in group V than in group C (p < 0.001).
The use of a continuous suture technique with unidirectional barbed sutures is as safe as the conventional suture technique and allows easier and faster suturing in the repair of perforated peptic ulcers.
腹腔镜下胃穿孔修补术是治疗穿孔性胃溃疡的主要方法之一，该技术需要可重复和安全的缝合。本研究旨在探讨新型连续缝合技术在腹腔镜胃穿孔修补术中的安全性和有效性。
收集 2009 年 11 月至 2015 年 10 月期间 116 例连续接受腹腔镜胃穿孔修补术的患者的临床资料。研究组（V 组，n=51）采用 15cm 长的单向可吸收带刺缝线进行连续缝合，而对照组（C 组，n=65）采用传统间断缝合。比较两组患者的并发症和手术数据。
虽然 V 组总并发症发生率（15.7%比 24.6%；p=0.259）与 C 组无差异，但 V 组与缝合相关的并发症发生率（3.9%比 15.4%；p=0.04）较低。V 组的漏液发生率为 0%，腹腔积液发生率为 2%，狭窄发生率为 2%；C 组的相应发生率分别为 3.1%、7.7%和 4.6%。就手术数据而言，V 组的总手术时间（87.7min 比 131.2min）、总缝合时间（7.1min 比 25.3min）和每针缝合时间（1.2min 比 6.2min）均显著短于 C 组（p<0.001）。
使用单向带刺缝线的连续缝合技术与传统缝合技术一样安全，并且可以更轻松、更快地缝合穿孔性胃溃疡。
