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单通道内镜牵引与吻合法在经内镜切除胃肠固有肌层肿瘤所致创面缝合中的应用价值。

The value of single-channel endoscopic traction and kiss suture technique in closing wounds caused by endoscopic resection of gastrointestinal muscularis propria tumors.

机构信息

Department of Gastroenterology, The Second Affiliated Hospital of Xiamen Medical College, No. 566 Jimei Shengguang Road, Xiamen, 361021, Fujian, China.

出版信息

Surg Endosc. 2023 Oct;37(10):7709-7716. doi: 10.1007/s00464-023-10277-6. Epub 2023 Aug 10.

DOI:10.1007/s00464-023-10277-6
PMID:37563343
Abstract

BACKGROUND

To investigate the value of single forceps endoscopic traction stapling suture technique (SFETSST) in closing wounds caused by endoscopic resection of gastrointestinal muscularis propria tumor (GMPT).

METHODS

Consecutive patients who underwent submucosal tumor excavation (ESE) and endoscopic full-thickness resection (EFR) for GMPT in the Second Affiliated Hospital of Xiamen Medical College from January 2015 to January 2022 were retrospectively collected. They were divided into the SFETSST group and the standard group (patients who receive single forceps traction-free endoscopic suture technique). The healing effects were compared between the two groups.

RESULTS

Seventy-seven patients were included in our study with 50 patients included in SFETSST group. The baseline characteristics had no significant difference between the two groups. The technical success rate of wound suture in SFETSST cluster was significantly upper than that within standard cluster (100% vs. 88.89%, P = 0.04). The wound suture time in SFETSST cluster was significantly lower than that within standard cluster (33.19 ± 10.64 min, P < 0.001). Moreover, the incidence rates of intra-operative and postoperative complications in SFETSST cluster were lower than standard cluster (0 vs. 7.41%, P = 0.051 and 0 vs. 11.11%, P = 0.016). Interestingly, the SFETSST cluster had lower cost of consumables (2485.40 ± 591.78 vs. 4098.52 ± 1903.06 Yuan, P = 0.01) and shorter hospital stay (4.96 ± 0.90 vs. 7.19 ± 2.45, P < 0.001) than standard cluster.

CONCLUSION

Our study showed that to fully closure the full-thickness defects of digestive tract, SFETSST was effective, safe, and economical, which was worth popularizing.

摘要

背景

探讨内镜下单纯抓钳牵引缝合技术(SFETSST)在闭合胃肠固有肌层肿瘤(GMPT)内镜切除创面中的价值。

方法

回顾性收集 2015 年 1 月至 2022 年 1 月厦门医学院附属第二医院行内镜黏膜下挖除术(ESE)和内镜全层切除术(EFR)治疗 GMPT 的连续患者,分为 SFETSST 组和标准组(接受单纯抓钳无牵引内镜缝合技术的患者)。比较两组的愈合效果。

结果

本研究共纳入 77 例患者,其中 SFETSST 组 50 例。两组基线特征无显著差异。SFETSST 组的创面缝合技术成功率明显高于标准组(100% vs. 88.89%,P=0.04)。SFETSST 组的缝合时间明显短于标准组(33.19±10.64 min,P<0.001)。此外,SFETSST 组术中及术后并发症发生率低于标准组(0 比 7.41%,P=0.051 和 0 比 11.11%,P=0.016)。有趣的是,SFETSST 组的耗材成本较低(2485.40±591.78 比 4098.52±1903.06 元,P=0.01),住院时间较短(4.96±0.90 比 7.19±2.45,P<0.001)。

结论

我们的研究表明,SFETSST 对于闭合消化道全层缺损是有效、安全且经济的,值得推广。

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