單鉗道鈦夾聯合尼龍圈“荷包”縫合胃黏膜下腫瘤全層切除創面缺損的效果

江小宇

【摘要】 目的：研究胃黏膜下腫瘤全層切除術（EFTR）術后創面缺損采用內鏡下單鉗道鈦夾聯合尼龍圈“荷包”縫合的臨床效果。方法：回顧性分析2016年2月-2017年7月在筆者所在醫院接受胃黏膜下腫瘤全層切除術治療的82例患者臨床資料，按照手術后止血方法分為觀察組和對照組，每組41例。對照組術后對創面予以常規止血處理，確定無活動性出血后結束手術。觀察組術后則對創面予以單鉗道內鏡下鈦夾聯合尼龍圈“荷包”縫合。比較兩組手術時間、縫合時間、術后住院時間、術后并發癥發生情況，以及術后12個月復發率、遠處轉移率。結果：觀察組與對照組的手術時間、縫合時間對比差異均無統計學意義（P>0.05）;但觀察組術后住院（5.62±1.19）d，短于對照組的（6.63±2.15）d。觀察組遲發性出血、遲發性穿孔、術后感染及術后腹痛發生率分別與對照組相比，差異均無統計學意義（P>0.05）。觀察組術后12個月復發率及遠處轉移率與對照組相比差異均無統計學意義（P>0.05）。結論：胃黏膜下腫瘤全層切除術后創面缺損采用單鉗道內鏡下鈦夾聯合尼龍圈“荷包”縫合效果較好，不會增加并發癥發生率，且不會增加術后復發率及遠處轉移率。

【關鍵詞】 胃部腫瘤; 黏膜下腫瘤; 單鉗道內鏡縫合

doi：10.14033/j.cnki.cfmr.2019.17.007 文獻標識碼 B 文章編號 1674-6805（2019）17-00-03

【Abstract】 Objective：To research the clinical effect of endoscopic single-channel titanium clip combined with nylon ring “Pouch” suture for wound defect after endo-scopic full-thickness resection（EFTR） of gastric submucosal tumors.Method：The clinical data of 82 patients receiving endo-scopic full-thickness resection of gastric submucosal tumors in our hospital from February 2016 to July 2017 were analyzed retrospectively.They were divided into the observation group and the control group by methods of hemostasis after operation，41 cases in each group.Patients in the control group were given routine treatment of wound hemostasis，no active bleeding after the end of surgery.In the observation group，single-channel titanium clip combined with nylon ring “Pouch” suture for wound defect after endo-scopic full-thickness resection was given to the wound after.The two groups were compared with operative time，suture time，postoperative hospital stay，recurrence rate of 12 months and the incidence of postoperative complications，distant metastasis rate.Result：The operation time and suture time of the observation group and the control group were not significantly different（P>0.05），but the postoperative hospitalization time of the observation group was （5.62±1.19）d，significantly lower than （6.63±2.15）d of the control group.The incidence of delayed bleeding，delayed perforation，postoperative infection and postoperative abdominal pain in the observation group compared with the control group，the differences were not statistically significant（P>0.05）.The recurrence rate and distant metastasis rate of the observation group at 12 months after operation compared with the control group，the differences were not statistically significant（P>0.05）.Conclusion：Titanium clip combined with nylon ring “Pouch” suture under single forceps endoscopy after total gastric submucosal tumor resection is effective，it will not increase the incidence of complications and the recurrence rate and distant metastasis rate after operation.