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带鱼钩状装置的牵引金属夹在内镜切除术后伤口缝合中的应用。

Application of a traction metal clip with a fishhook-like device in wound sutures after endoscopic resection.

作者信息

Fangjun Wang, Xia Leng, Yi Gao, Xiuyun Shen, Wenping Wang, Huamin Liu, Pengfei Liu

机构信息

Department of Gastroenterology, Jiangyin Hospital Affiliated to Nantong University, Jiangyin, China.

出版信息

Clin Endosc. 2022 Jul;55(4):525-531. doi: 10.5946/ce.2021.241. Epub 2022 Jul 28.

DOI:10.5946/ce.2021.241
PMID:35898150
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9329651/
Abstract

BACKGROUND/AIMS: Endoscopic wound suturing is an important factor that affects the ability to remove large and full-thickness lesions during endoscopic resection. We aimed to evaluate the effect of a traction metal clip with a fishhook-like device on wound sutures after endoscopic resection.

METHODS

From July 2020 to April 2021, patients who met the enrollment criteria were treated with a fishhook-like device during the operation to suture the postoperative wound (group A). Patients with similar conditions and similar size wounds who were treated with a "purse-string suture" to suture the wounds were retrospectively analyzed as the control group (group B). Difference in the suture rate, adverse events, time required for suturing, and number of metal clips were compared between the two groups.

RESULTS

The time required for suturing was 7.72±0.51 minutes in group A and 11.50±0.91 minutes in group B. This difference was statistically significant (F=13.071, p=0.001). The number of metal clamps used in group A averaged 8.1 pieces/case, and the number of metal clamps used in group B averaged 7.3 pieces/case. This difference was not statistically significant (F=0.971, p>0.05).

CONCLUSION

The traction metal clip with the fishhook-like device is ingeniously designed and easy to operate. It has a good suture effect on the wound after endoscopic submucosal dissection and effectively prevents postoperative adverse events.

摘要

背景/目的：内镜下伤口缝合是影响内镜切除术中大块全层病变切除能力的重要因素。我们旨在评估带鱼钩状装置的牵引金属夹在内镜切除术后伤口缝合中的效果。

方法

2020年7月至2021年4月，符合纳入标准的患者在手术期间使用鱼钩状装置缝合术后伤口（A组）。对采用“荷包缝合”缝合伤口的病情相似、伤口大小相近的患者进行回顾性分析作为对照组（B组）。比较两组的缝合率、不良事件、缝合所需时间和金属夹数量的差异。

结果

A组缝合所需时间为7.72±0.51分钟，B组为11.50±0.91分钟。这种差异具有统计学意义（F=13.071，p=0.001）。A组平均每例使用金属夹8.1枚，B组平均每例使用金属夹7.3枚。这种差异无统计学意义（F=0.971，p>0.05）。

结论

带鱼钩状装置的牵引金属夹设计巧妙，操作简便。它在内镜黏膜下剥离术后对伤口具有良好的缝合效果，能有效预防术后不良事件。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/30f6/9329651/76a3cfc04b10/ce-2021-241f4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/30f6/9329651/12b535494152/ce-2021-241f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/30f6/9329651/e390b5a65ccf/ce-2021-241f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/30f6/9329651/e2b8798e5425/ce-2021-241f3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/30f6/9329651/76a3cfc04b10/ce-2021-241f4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/30f6/9329651/12b535494152/ce-2021-241f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/30f6/9329651/e390b5a65ccf/ce-2021-241f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/30f6/9329651/e2b8798e5425/ce-2021-241f3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/30f6/9329651/76a3cfc04b10/ce-2021-241f4.jpg

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A novel endoscopic hand-suturing technique for defect closure after colorectal endoscopic submucosal dissection: a pilot study.
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