两种不同缝合材料在儿童腹腔镜阑尾切除术中阑尾残端闭合的应用

Osman Uzunlu
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摘要

目的:评价我们临床使用的两种不同缝线材料与文献中发表的缝线材料缝合阑尾基底的效果。材料与方法:回顾性分析36例儿童腹腔镜阑尾切除术的临床资料。将患者分为两组:Vicryl缝合组和silk缝合组。研究了实验室结果、诊断算法、手术技术和并发症。结果:男性16例(44%),女性20例(56%)。所有患者平均住院时间为2.22±1.6天(范围:1 ~ 7天)。薇薇组WBC、CRP均值分别为14.67±5.8 × 109/L、139.3±120 mg/L,蚕丝组15.36±6.4 × 109/L、86±80 mg/L。维维林组9例,蚕丝组6例出现小肠梗阻。超声检查31例,阑尾可见21例(67%)。静脉CT增强成像25例。腹腔镜探查时20例为并发症,其中穿孔17例,坏疽3例。所有病例均应用广谱抗生素治疗。平均随访43个月(范围:10 ~ 117个月);所有患者均未出现术中并发症,仅有2例患者术后出现轻微并发症。结论:在任何情况下,无论阑尾的直径如何,阑尾残端都可以用丝质和薇丝缝合材料安全闭合。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Closure of the appendix stump with two different suture materials in laparoscopic appendectomy in children
Purpose: To evaluate the outcomes of the closure of the appendix base using two different suture materials that we used in our clinic with those published in the literature. Materials and methods: The study retrospectively reviews 36 cases of children who underwent laparoscopic appendectomies. The patients were divided into two groups: the Vicryl suture group and the silk suture group. Laboratory results, diagnostic algorithms, surgical techniques, and complications were investigated. Results: Sixteen (44%) of the cases were male, and twenty (56%) were female. All patients' mean hospital admission time was 2.22±1.6 days (range: 1–7 days). The mean WBC and CRP levels were 14.67±5.8x109/L, 139.3±120 mg/L in the vicryl group and 15.36±6.4x109/L and 86±80 mg/L in the silk group. Small bowel obstruction was observed in nine patients in the vicryl group and six patients in the silk group. Ultrasonography was performed in 31 of the cases, the appendix was visualized in 21 cases (67%).Intravenous contrast-enhanced CT imaging was applied in 25 cases. At laparoscopic exploration, 20 cases were classified as complicated—17 due to perforation, and 3 due to gangrene. All cases were treated with broad-spectrum antibiotics. The mean follow-up period was 43 months (range: 10-117 months); none of the patients experienced intraoperative complications, and only two patients had minor complications in the postoperative period. Conclusion: In all circumstances and regardless of the appendix's diameter, the appendix stump can be securely closed with both silk and vicryl suture material.
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