Absorbable ligating clip in laparoscopic hysterectomy

doi:10.3969/j.issn.2095-4344.2014.34.026

Abstract

Abstract:

BACKGROUND: Titanium clip, commonly used in abdominal surgery and obstetrics and gynecology surgery, has a great damage to the vascular tissue, and its excessive clipping can cut off the vessel and produce artifacts and deflection MRI on MRI and CT scan. In addition, its biocompatibility is not well that increases the risks for local inflammatory response and scarring.

OBJECTIVE: To observe the clinical efficacy of absorbable ligating clip in laparoscopic hysterectomy and to evaluate its clinical value.

METHODS: Ninety-eight patients undergoing laparoscopic hysterectomy were randomly divided into two groups: 49 patients in the observation group were subjected to occlusion of the uterine artery by a Johnson absorbable ligating chip and then complete removal of the uterus; 49 patients in the control group were subjected to occlusion of the uterine artery with a titanium clip. Hospital stay and postoperative complications were recorded and analyzed between the two groups.

RESULTS AND CONCLUSION: The use of absorbable ligating clip in laparoscopic hysterectomy significantly shortened the hospital stay, and postoperative pain, adhesions, pelvic fluid, fever and other complications were significantly reduced (P < 0.05). In addition, no postoperative infection occurred in the two groups and there was no significant difference in the class A healing rate between the two groups (P > 0.05). The results suggest that absorbable ligating clip with better biocompatibility can help to reduce tissue reactions and promote tissue repair, which is characterized as effective, safe and reliable.

中国组织工程研究杂志出版内容重点：生物材料；骨生物材料; 口腔生物材料; 纳米材料; 缓释材料; 材料相容性；组织工程

全文链接：

Key words: biocompatible materials, absorbable implants, postoperative complications

CLC Number:

R318

Li A-li. Absorbable ligating clip in laparoscopic hysterectomy[J]. Chinese Journal of Tissue Engineering Research, 2014, 18(34): 5561-5565.

Figures/Tables 3

2.1 参与者数量分析按意向性处理分析，98例患者均完成了3个月的随访，进入结果分析，无脱落者。 2.2 基线资料分析两组患者的年龄、病程等均具有可比性，见表1。 2.3 可吸收结扎钉夹应用对腹腔镜下子宫全切患者术后疼痛、盆腔积液及外周血白细胞计数的影响见图1。腹部疼痛：术后1周内观察组出现3例(6%)腹痛患者，对照组出现11例(22%)腹痛，腹痛发生率组间比较差异有显著性意义(χ2=4.08，P < 0.05)。盆腔积液：术后1个月盆腔B超检查显示，观察组发生盆腔积液2例(4%)，对照组发生10例盆腔积液(20%)，盆腔积液发生率组间比较差异有显著性意义(χ2=4.65，P < 0.05)。妇检异常：术后3个月妇科双合诊存在压痛或粘连感，观察组2例(4%)，对照组6例(12%)，妇检异常发生率组间比较差异无显著性意义(χ2=1.225，P > 0.05)。白细胞计数升高：术后3 d外周血白细胞计数升高，有感染倾向者，观察组3例(6%)，对照组发生15例(31%)，白细胞升高发生率组间比较差异有非常显著性意义(χ2=8.23， P < 0.01)。以上结果说明术中应用可吸收结扎钉夹夹闭子宫动脉可降低腹腔镜下子宫全切患者术后疼痛、盆腔积液及外周血白细胞计数，提示生物相容性更好的可吸收结扎钉夹有助于减轻组织反应，促进受创组织的修复。 2.4 可吸收结扎钉夹应用对腹腔镜下子宫全切患者患者住院时间、并发症及愈合的影响住院时间：观察组住院时间为(3.5±1.4) d，对照组住院时间为(5.8±1.5) d，观察组住院时间短于对照组，组间比较差异有显著性意义(t=7.85，P < 0.05)，见图2。并发症：观察组术后轻度发热1例，经对症治疗好转；对照组5例发热，2例发生水电解质失衡，经对症治疗好转，组间并发症发生率比较差异有显著性意义(2%，14%，χ2= 4.9，P < 0.05)，见图3。两组均未发生感染。创口愈合：观察组创口甲级愈合47例，对照组创口甲级愈合45例，组间比较差异无显著性意义(χ2=0.71，P > 0.05)，见图3。以上结果说明腹腔镜下子宫全切术中应用可吸收结扎钉夹夹闭子宫动脉，可显著缩短住院时间，降低术后并发症发生率；此外，两组患者术后均未发生感染，甲级愈合率组间无显著差异，提示医用生物性可吸收降解材料用于妇产科手术具有与传统医用耗材相当的效能。"

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