“一针法”皮内连续缝合在腹腔镜胃肠肿瘤手术辅助切口中的应用  

One-stitch intracutaneous continuous suture technique for adjuvant incision in laparoscopic gastrointes-tinal tumor surgery

作　　者：邓伟浩 俞金龙[1] 邹兆伟[1] Deng Weihao;Yu Jinlong;Zou Zhaowei(Department of General Surgery,Zhujiang Hospital of Southern Medical University,Guangzhou 510220,Guangdong,China)

机构地区：[1]南方医科大学珠江医院普通外科,广东广州510220

出　　处：《中国现代手术学杂志》2023年第2期86-90,共5页Chinese Journal of Modern Operative Surgery

基　　金：国家自然科学基金(81901987)。

摘　　要：目的探讨“一针法”连续缝合技术在腹腔镜胃肠肿瘤手术辅助切口中的应用效果。方法回顾性分析2021年9月至2022年9月行腹腔镜胃肠肿瘤手术的101例患者的临床资料,根据辅助切口的缝合方式将其分为两组:观察组57例,其中胃癌19例,右半结肠癌18例,左半结肠癌6例,乙状结肠癌14例,采用“一针法”皮内连续缝合;对照组44例,其中胃癌15例,右半结肠癌11例,左半结肠肿瘤8例,乙状结肠癌10例,采用传统间断褥式缝合。比较两组切口缝合时间、术后换药次数、术后1周疼痛VAS评分、切口愈合不良事件(如脂肪液化、切口感染、切口裂开)、切口疝发生率以及患者对切口外观满意度。结果两组患者均顺利完成手术,无中转开腹,术后无严重并发症。两组比较,观察组在术中缝合时间、术后换药次数、切口愈合不良事件率及患者切口外观满意度上均明显优于对照组(P<0.05),两组术后1周VAS评分及术后切口疝发生率比较无统计学差异(P>0.05)。术后观察组发生脂肪液化2例,无一例切口感染,对照组脂肪液化5例,切口感染4例。两组患者均无伤口裂开。结论“一针法”皮内连续缝合应用于腹腔镜胃肠肿瘤手术辅助切口,具有提高切口愈合质量、缩短手术时长的优势,还可减少术后换药次数,提高患者满意度,值得临床推广应用。Objective To investigate the effect of the one-stitch technique of continuous intradermal suturing in laparoscopic gastrointestinal tumor surgery with adjuvant incisions.Methods A retrospective analysis was carried out in 101 patients who underwent laparoscopic gastrointestinal tumor surgery from September 2021 to September 2022.All cases were divided into the observation group(n=57)and the control group(n=44)according to the suturing method of adjuvant incision,and performed one-stitch technique of continuous intradermal suture and the traditional interrupted mattress suture technique respectively.The incision closure time,postoperative dressing change times,pain score of visual analog scale(VAS),incidence of adverse incision healing events(as fat liquefaction,incision infection and incision dehiscence),incisional hernia rate and patient's satisfaction with incision appearance were compared between the two groups.Results All laparoscopic gastrointestinal tumor surgery was completed successfully in both groups without conversion of open surgery and serious postoperative complications.Compared with the control group,the intraoperative suture time was shorter,postoperative dressing changes times was less,the adverse event rate of incision healing was lower,and the patient's satisfaction with incision appearance was higher in the observation group,with statistically significant differences(P<0.05),but no statistical difference in VAS score one week after the surgery and incisional hernia rate between the two groups(P>0.05).Fat liquefaction was found in 2 cases of the observation group,and fat liquefaction in 5 cases and incision infection in 4 cases of the control group,and no wound dehiscence occurred in both groups.Conclusion The technique of one-stitch continuous intradermal suturing can improve the quality of incision healing,shorten the operation time,reduce postopera-tive dressing changes times and improve patient's satisfaction for adjuvant incision in laparoscopic gastroin-testinal tumor surgery,and is worth

关 键 词：皮内缝合 一针法 切口 腹腔镜手术 

分 类 号：R735[医药卫生—肿瘤]