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倒刺缝线在腹腔镜右半结肠切除体内吻合术后肠切开缝合中的应用。一项前瞻性描述性研究。

Use of barbed suture for the closure of enterocolotomy after laparoscopic right hemicolectomy with intracorporeal anastomosis. A prospective descriptive study.

作者信息

Ferrer-Márquez Manuel, Torres-Fernández Rocio, Rubio-Gil Francisco, Belda-Lozano Ricardo, Moya-Forcén Pedro, Benavides Buleje Jorge Alejandro, Reina-Duarte Ángel

机构信息

Unidad de Coloproctología, Servicio de Cirugía General y Digestiva, Hospital Universitario Torrecárdenas, Almería, España.

Unidad de Coloproctología, Servicio de Cirugía General y Digestiva, Hospital Universitario Torrecárdenas, Almería, España.

出版信息

Cir Esp (Engl Ed). 2020 Mar;98(3):136-142. doi: 10.1016/j.ciresp.2019.10.002. Epub 2019 Dec 6.

Abstract

INTRODUCTION

Performing intracorporeal anastomoses and sutures is possibly the technique that requires the greatest skill in laparoscopic surgery. The appearance of the new barbed sutures in recent years has seemed to facilitate this surgical step. The aim of our study is to evaluate short-term results in patients with neoplasms of the right colon, after laparoscopic right hemicolectomy with intracorporeal anastomosis using barbed suture at the closure of the enterocolotomy.

METHODS

This is a multicenter, prospective, descriptive study that includes patients who underwent laparoscopic right hemicolectomy for neoplastic colonic pathologies between June 2015 and December 2018. In all patients, the intracorporeal anastomosis was performed using the endocutter, and closure of the enterocolotomy was done with a double layer of barbed suture.

RESULTS

A total of 80 patients were treated (47.5% women), with an average age of 70.6±9 (49-92) years. The average operative time was 99.5±38minutes Anastomotic dehiscence was observed in 2.5% of the sample, and 5 patients required re-operation (6.2%) as a result of 2leaks, 2obstructive symptoms and one peritoneal bleeding. Mean hospital stay was 7 (3-173) days.

CONCLUSIONS

The use of barbed suture in laparoscopic right hemicolectomy with intracorporeal anastomosis seems to present a morbidity similar to series described in literature. Prospective, controlled and randomized studies with a larger number of patients would be necessary to confirm these findings.

摘要

引言

进行体内吻合和缝合可能是腹腔镜手术中要求最高技能的技术。近年来新型倒刺缝线的出现似乎使这一手术步骤变得更加容易。我们研究的目的是评估在腹腔镜右半结肠切除术中使用倒刺缝线进行肠切开吻合术后,右半结肠肿瘤患者的短期结果。

方法

这是一项多中心、前瞻性、描述性研究,纳入了2015年6月至2018年12月期间因结肠肿瘤性病变接受腹腔镜右半结肠切除术的患者。所有患者均使用内镜切割器进行体内吻合,并用双层倒刺缝线关闭肠切开处。

结果

共治疗80例患者(女性占47.5%),平均年龄70.6±9(49 - 92)岁。平均手术时间为99.5±38分钟。样本中2.5%观察到吻合口裂开,5例患者(6.2%)因2例渗漏、2例梗阻症状和1例腹腔出血需要再次手术。平均住院时间为7(3 - 173)天。

结论

在腹腔镜右半结肠切除术中使用倒刺缝线进行体内吻合,其发病率似乎与文献中描述的系列研究相似。需要进行更多患者的前瞻性、对照和随机研究来证实这些发现。

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