腹腔镜下倒刺缝线与可吸收缝线行十二指肠菱形吻合的效果比较

Comparison of unidirectional barb suture and absorbable suture on the laparoscopic duodena-jejunal bypass of duodenum

摘要:

摘要：目的 评价环状胰腺患儿在腹腔镜十二指肠菱形吻合术中，予以单向倒刺缝线吻合的安全性及有效性。方法 选取2016年1月－2018年4月于成都市妇女儿童中心医院就诊并行腹腔镜十二指肠菱形吻合术治疗的21例环状胰腺患儿进行前瞻性研究。将其按照随机数字表法随机分为两组，实验组8例在术中采用倒刺缝线连续行十二指肠菱形吻合术，对照组13例在术中采用可吸收缝线行十二指肠菱形吻合术。比较两种缝合方式在缝合时间、术中及术后肠瘘发生率、术后引流量和胃肠减压引流量的差异。结果 两组患儿均成功于腹腔镜下完成手术，无中转开腹。其中，实验组缝合时间比对照组短，差异有统计学意义[（15.13±1.96）和（17.46±1.61）min，t =-2.97，P <0.05]，实验组术后引流液重量明显低于对照组，差异有统计学意义（P <0.05）；但术中及术后肠漏的发生率和胃肠引流量两组比较，差异均无统计学意义（P >0.05）。结论 在腹腔镜下行十二指肠菱形吻合术时，倒刺缝线与传统可吸收缝线相比，具有缝合时间短和术后引流液少等特点，值得临床推广。

Abstract:

Abstract: Objective To investigate the safety and efficacy of unidirectional barbed suture in annular pancreas children of laparoscopic duodena-jejunal bypass of duodenum. Methods 21 children with annular pancreas underwent laparoscopic duodena-jejunal bypass of duodenum from January 2016 to April 2018 and were prospectively analyzed. According to the random number table method, children patients were randomly divided into unidirectional barbed suture group (n = 8) for laparoscopic duodena-jejunal bypass of duodenum and normal absorbable suture group for laparoscopic duodena-jejunal bypass of duodenum (n = 13). Compare with the differences of the two suture methods in operation time, incidence of intestinal leakage (intraoperative and postoperative), weight of postoperative drainage, weight of gastrointestinal decompression drainage fluid. Results All the children were successfully operated without conversion to open surgery, and the time of duodena-jejunal bypass suture closure in unidirectional barbed suture group was less than that in normal absorbable suture group [(15.13 ± 1.96) min vs (17.46 ± 1.61) min, t = -2.97, P < 0.05]. The weight of postoperative drainage of duodena-jejunal bypass suture closure in unidirectional barbed suture group was also less than that in normal absorbable suture group [(19.94 ± 6.67) g vs (22.25 ± 6.94) g, t = -2.31, P < 0.05] The incidence of intestinal leakage (intraoperative and postoperative) and the weight of gastrointestinal decompression drainage fluid between the two groups were not statistically significant (P > 0.05). Conclusions Compare of normal absorbable suture, unidirectional barbed suture is short of suture time and less drainage after operation in laparoscopic duodena-jejunal bypass of duodenum, so it is worth popularizing in clinic.