CAJ | 학술논문

目的评价金属夹联合新型尼龙绳(乐奥尼龙绳)缝合内镜全层切除术后胃壁全层缺损的可行性及安全性.方法回顾分析2014年10月至2015年2月32例胃底黏膜下肿瘤行内镜全层切除术治疗患者的临床资料,其中14例采用金属夹联合乐奥尼龙绳缝合胃壁缺损(研究组),其余18例采用金属夹联合Olympus尼龙绳缝合胃壁缺损(对照组),比较2组闭合完成情况、并发症发生情况及创面愈合情况.结果 2组均顺利完成所有内镜全层切除术,胃壁缺损闭合成功率均为100％.研究组耗时(13.86±4.62) min,对照组耗时(18.28±6.48) min,差异有统计学意义(P＜0.05).研究组和对照组分别使用金属夹(9.43±4.09)枚和(9.67±3.61)枚,尼龙绳(1.00±0.00)枚和(1.06±0.24)枚,差异均无统计学意义(P＞0.05).研究组和对照组术中分别有1例和2例因气腹明显予腹腔穿刺抽气治疗,差异无统计学意义(P＞0.05).2组术后均无皮下气肿、气胸、纵隔气肿,均未见迟发出血及腹腔感染症状,术后2个月创面均完全愈合.结论金属夹联合乐奥尼龙绳缝合内镜全层切除术后胃壁缺损安全和有效,具有较好的临床应用价值.
목적 평개금속협연합신형니룡승(악오니룡승)봉합내경전층절제술후위벽전층결손적가행성급안전성.방법 회고분석2014년10월지2015년2월32례위저점막하종류행내경전층절제술치료환자적림상자료,기중14례채용금속협연합악오니룡승봉합위벽결손(연구조),기여18례채용금속협연합Olympus니룡승봉합위벽결손(대조조),비교2조폐합완성정황、병발증발생정황급창면유합정황.결과 2조균순리완성소유내경전층절제술,위벽결손폐합성공솔균위100％.연구조모시(13.86±4.62) min,대조조모시(18.28±6.48) min,차이유통계학의의(P＜0.05).연구조화대조조분별사용금속협(9.43±4.09)매화(9.67±3.61)매,니룡승(1.00±0.00)매화(1.06±0.24)매,차이균무통계학의의(P＞0.05).연구조화대조조술중분별유1례화2례인기복명현여복강천자추기치료,차이무통계학의의(P＞0.05).2조술후균무피하기종、기흉、종격기종,균미견지발출혈급복강감염증상,술후2개월창면균완전유합.결론 금속협연합악오니룡승봉합내경전층절제술후위벽결손안전화유효,구유교호적림상응용개치.
Objective To evaluate a new type of endoloop for closure of full-thickness gastric defects left by EFR.Methods A total of 32 patients who underwent EFR at our hospital between October 2014 and February 2015 with gastric fundus submucosal tumors were retrospectively analyzed.After the resection,LeCampTM endoloops and Olympus endoloops were used respectively to close the gastric defect in the study group (n =14) and the control group(n =18).The closure success rates,closure time,complications and the healing rates were compared.Results All lesions were removed by using EFR technique.The closure success rates of the two groups were both 100％.The closure time were 13.86 ± 4.62 minutes and 18.28 ± 6.48 minutes in study group and control group respectively with significant difference (P ＜ 0.05).9.43 ±4.09 metallic clips and 1.00 ±0.00 endoloops were used in study group and 9.67 ± 3.61 metallic clips and 1.06 ± 0.24 endoloops were used in control group (P ＞ 0.05).One patient in study group and 2 patients in control group received abdominal puncture for relieving the pneumoperitoneum during the operation (P ＞ 0.05).No complications such as subcutaneous emphysema,pneumothorax,pneumomediastinum,delayed bleeding,or abdominal infection were found after the operations in either group.The wounds healed in all patients in 2 months after the procedure.Conclusion The use of novel endoloop and metallic clips is a relatively safe,easy,and feasible method for repairing large gastric post-EFR defects,which is of good clinical application value.