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腹腔镜手术后切口关闭技术的比较临床研究

Comparative clinical study of port-closure techniques following laparoscopic surgery.

作者信息

Elashry O M, Nakada S Y, Wolf J S, Figenshau R S, McDougall E M, Clayman R V

机构信息

Department of Surgery, Mallinckrodt Institute of Radiology.

出版信息

J Am Coll Surg. 1996 Oct;183(4):335-44.

PMID:8843262
Abstract

BACKGROUND

Recently, a number of laparoscopic port-closure techniques have been reported to avoid the complications associated with the port closure after laparoscopic surgery. To evaluate these port-closure techniques, we compared seven new laparoscopic port-closure techniques with the standard technique of a hand-sutured closure.

STUDY DESIGN

In a prospective, randomized study, 95, 12-mm port sites in 32 patients undergoing transperitoneal laparoscopic procedures were randomized to one of eight different port-site closure techniques. The port-closure techniques included: the Carter-Thomason Needle-Point Suture Passer, Maciol suture needle set, eXit Disposable Puncture Closure device, Endoclose suture carrier, Tahoe Surgical Instruments Ligature device, a long 14-gauge angiocatheter with looped polypropylene suture, Lowsley retractor with hand-sutured closure, and the standard technique of hand-sutured closure. We evaluated the time, the security, and the auxiliary instrumentation required for each closure.

RESULTS

Of the port-closure techniques, the Carter-Thomason device was faster overall, resulted in fewer port-closure-related complications and provided a leak proof closure.

CONCLUSIONS

The Carter-Thomason device is our preferred method for the closure of port sites after laparoscopic surgery.

摘要

背景

最近,有多项腹腔镜切口关闭技术被报道可避免腹腔镜手术后与切口关闭相关的并发症。为评估这些切口关闭技术,我们将七种新型腹腔镜切口关闭技术与手工缝合关闭的标准技术进行了比较。

研究设计

在一项前瞻性随机研究中,对32例行经腹腹腔镜手术患者的95个12毫米切口部位进行随机分组,采用八种不同的切口关闭技术之一。这些切口关闭技术包括:卡特 - 托马森针尖缝线导入器、马乔尔缝合针套件、Exit一次性穿刺闭合装置、Endoclose缝线输送器、塔霍手术器械结扎装置、带环聚丙烯缝线的14号长血管导管、带手工缝合关闭的劳斯利牵开器以及手工缝合关闭的标准技术。我们评估了每种关闭方式所需的时间、安全性和辅助器械。

结果

在这些切口关闭技术中,卡特 - 托马森装置总体上更快,导致与切口关闭相关的并发症更少,并提供了防漏闭合。

结论

卡特 - 托马森装置是我们腹腔镜手术后切口关闭的首选方法。

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