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单孔腹腔镜手术中的脐部缝合法技术

Umbilical Quilting Suture Technique during Single-Port Laparoscopic Surgery.

作者信息

Chang Jung Woo, Oh Jeongseok, Jung Un Suk

机构信息

Department of Plastic and Reconstructive Surgery.

Department of Obstetrics and Gynecology, Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri, Korea.

出版信息

JSLS. 2018 Jan-Mar;22(1). doi: 10.4293/JSLS.2017.00088.

Abstract

BACKGROUND AND OBJECTIVES

Single-port laparoscopic surgery (SPLS) is popular in the gynecological field, because it is less invasive and leaves a smaller scar. However, the postoperative shape of the umbilicus is often distorted due to the intensive procedures performed through the small opening. In this report, we describe a technique for forming a satisfactory umbilicus in SPLS.

METHODS

From March 2016 through April 2017, 32 patients were treated with SPLS by a single gynecologic surgeon. Group A (14 cases) underwent conventional umbilicus closure, and group B (18 cases) underwent a quilting suture technique. The umbilical shapes of each group were assessed by a plastic surgeon as was the patients' satisfaction. Evaluations were performed immediately after surgery and every month for 6 months thereafter.

RESULTS

The postoperative umbilical shape in group A showed features, such as loss of depression, disappearance of the central vertical line, and irregularly bulging tissue, whereas group B had a shape similar to that of the natural umbilicus and maintained its depression and vertical line. The average scores of the plastic surgeons' evaluations immediately after the operation were 10.4 for group A and 15.1 for group B. The final scores obtained 6 months after surgery were 15.2 and 17.8, respectively. The patients' satisfaction scores immediately after the operation were 4.9 for group A and 7.3 for group B. The scores increased gradually, to 8.1 and 9.2, respectively, at 6 months after surgery.

CONCLUSION

Performing quilting sutures during wound closure in SPLS is effective for making an ideal umbilicus and ensuring patients' satisfaction.

摘要

背景与目的

单孔腹腔镜手术(SPLS)在妇科领域很受欢迎,因为它侵入性较小且疤痕较小。然而,由于通过小切口进行的密集操作,术后脐部形状常常变形。在本报告中,我们描述了一种在单孔腹腔镜手术中形成令人满意的脐部的技术。

方法

2016年3月至2017年4月,由一名妇科外科医生对32例患者进行了单孔腹腔镜手术。A组(14例)采用传统的脐部缝合,B组(18例)采用褥式缝合技术。由一名整形外科医生评估每组的脐部形状以及患者的满意度。在手术后立即进行评估,并在之后的6个月内每月评估一次。

结果

A组术后脐部形状呈现出诸如凹陷消失、中央垂直线消失以及组织不规则隆起等特征,而B组的形状与自然脐部相似,保持了其凹陷和垂直线。术后立即进行的整形外科医生评估的平均分数,A组为10.4分,B组为15.1分。术后6个月获得的最终分数分别为15.2分和17.8分。术后立即进行的患者满意度分数,A组为4.9分,B组为7.3分。分数逐渐增加,在术后6个月时分别升至8.1分和9.2分。

结论

在单孔腹腔镜手术的伤口闭合过程中进行褥式缝合,对于形成理想的脐部和确保患者满意度是有效的。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d98b/5863694/05bfd9141e89/jls0201636890001.jpg

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