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首页> 外文期刊>Journal of Clinical and Diagnostic Research >Comparison of Unidirectional and Bidirectional Barbed Suture in Vaginal Cuff Closure during Total Laparoscopic Hysterectomy- A Randomised Controlled Trial
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Comparison of Unidirectional and Bidirectional Barbed Suture in Vaginal Cuff Closure during Total Laparoscopic Hysterectomy- A Randomised Controlled Trial

机译：腹腔镜子宫切除术期间阴道袖带闭合在腹腔镜子宫切除术期间的单向和双向刺缝合的比较 - 随机对照试验

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Laparoscopic hysterectomy is increasingly replacing abdominal hysterectomy in many countries. The advantages of laparoscopic approach include short postoperative recovery time and hospitalisation time. However, vaginal cuff closure during laparoscopic hysterectomy can be challenging, especially for beginners. Barbed sutures have been found to be superior to conventional sutures for vaginal cuff closure during laparoscopic hysterectomy in several studies. However, studies comparing different barbed sutures are lacking.Aim: To compare vaginal cuff closure time, operative time and complications between unidirectional and bidirectional barbed suture during Total Laparoscopic Hysterectomy (TLH).Materials and Methods: A randomised, controlled clinical trial was conducted from November 2017 to March 2019, in a Medical College in Puducherry, India that involved 46 women, who underwent TLH for benign pathology. After TLH, vaginal cuff closure method was randomised to unidirectional barbed suture or bidirectional barbed suture. The vaginal cuff closure time, total operative time and complications were recorded. The patients were evaluated postoperatively at 4 weeks after the surgery and by phone interview at 6 months. The comparison between the continuous variables was done with independent Students t-test or Mann-Whitney U Test and categorical variables with Chi-square or fisher-exact test. A p-value of <0.05 was considered as statistically significant.Results: The mean time taken for vaginal cuff closure by unidirectional barbed suture group was 6.8±1.6 minutes and bidirectional barbed suture was 11.3±1.46 minutes (p<0.001). The mean operative time in the unidirectional barbed suture group was 139±48.3 minutes and in the bidirectional barbed suture group was 150.6±42.7 minutes (p=0.39). The frequency of postoperative complications such as bleeding, infection and cuff dehiscence were not statistically significant between the two groups.Conclusion: Vaginal cuff closure time using unidirectional barbed suture is significantly less when compared to bidirectional barbed suture during TLH.
机译：腹腔镜子宫切除术越来越多地替代许多国家的腹腔切除术。腹腔镜方法的优点包括术后恢复时间和住院时间。然而，腹腔镜子宫切除术期间的阴道袖带闭合可能是挑战，特别是对于初学者来说。已经发现刺绣缝合线优于腹腔镜子宫切除术期间的阴道袖带闭合缝合线。然而，缺乏不同的倒钩缝合线的研究。目的：在总腹腔镜子宫颈术（TLH）期间，比较阴道袖带闭合时间，单向和双向刺缝合缝合线之间的手术时间和并发症。材料和方法：随机，受控临床试验于2017年11月至2019年3月，在印度普渡港的一所医学院，涉及46名妇女，为良性病理学接受了TLH。在TLH之后，阴道袖带封闭方法随机分配到单向吹刺缝合或双向刺缝合。记录了阴道袖口闭合时间，总操作时间和并发症。患者在手术后4周左右进行评估，并通过6个月通过电话采访。连续变量之间的比较是用独立学生T检验或Mann-Whitney U测试和分类变量与Chi-Square或Fisher精确测试完成。 p值为<0.05被认为是统计学意义。结果：单向刺缝合组阴道袖带闭合所采取的平均时间为6.8±1.6分钟，双向刺缝合线为11.3±1.46分钟（P <0.001） 。单向刺缝合缝合组中的平均手术时间为139±48.3分钟，在双向刺缝缝合组中为150.6±42.7分钟（P = 0.39）。两组之间的出血，感染和袖带裂开等术后并发症的频率在两组之间没有统计学意义。结论：与在TLH的双向刺绣缝合相比，使用单向刺缝合的阴道袖带闭合时间明显较低。

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