Leppäniemi A K, Wherry D C, Pikoulis E, Hufnagel H V, Fishback N, Rich N M
Department of Surgery, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA.
Urology. 1998 Apr;51(4):553-7. doi: 10.1016/s0090-4295(97)00694-8.
Vascular closure staple (VCS) clips made of titanium were initially developed for microvascular anastomoses with little knowledge of their effectiveness in larger tubular tissue structures. This study compares VCS clips and sutures in the closure of longitudinal ureterotomy incisions.
In 9 pigs, 1-cm-long anterior, longitudinal ureterotomy incisions were randomly assigned to closure with either 4-0 interrupted polyglactin sutures or VCS clips.
Clip closure was significantly faster (74+/-28 versus 534+/-182 seconds). All 18 ureters were patent and without signs of leakage, calculus formation, or stenoses after 3 months. Clip closure resulted in slightly but not statistically significantly less narrowing of the duct lumen, but there was no difference in wall thickness at the repair site. At histologic examination, all 18 incisions healed without signs of acute inflammation or marked fibrosis.
Ureterotomy closure with VCS clips results in wound healing that is as effective as suture closure, with a comparable degree of narrowing. The time required for clip closure is only about 1/7 that required for suture closure.
钛制血管闭合钉（VCS）最初是为微血管吻合术开发的，对其在较大管状组织结构中的有效性了解甚少。本研究比较了VCS钉和缝线在纵向输尿管切开切口闭合中的应用。
在9头猪中，将1厘米长的前侧纵向输尿管切开切口随机分配用4-0间断聚乙醇酸缝线或VCS钉进行闭合。
用钉闭合明显更快（74±28秒对534±182秒）。3个月后，所有18条输尿管均通畅，无渗漏、结石形成或狭窄迹象。用钉闭合导致管腔狭窄略少但无统计学显著差异，但修复部位的壁厚无差异。组织学检查时，所有18个切口愈合，无急性炎症或明显纤维化迹象。
用VCS钉闭合输尿管切开术导致伤口愈合与缝线闭合一样有效，狭窄程度相当。用钉闭合所需时间仅约为缝线闭合所需时间的1/7。
