探讨QuillTM缝线在腹腔镜肾部分切除术应用中的安全性及有效性。

回顾性分析2015年6月至2020年1月西藏自治区人民医院泌尿外科完成的腹腔镜肾部分切除术38例，根据应用缝合线的不同分为普通缝线组和QuillTM缝线组。普通缝线组20例，均采用2-0单乔线缝合内层，线尾固定Hem-o-lok夹，1-0可吸收线缝合肾缺损，出肾被膜每针均固定1个Hem-o-lok夹；QuillTM缝线组18例，均采用2-0倒刺线缝合内层，1-0倒刺线缝合肾缺损处，采用连续缝合，最后肾被膜出针处固定1个Hem-o-lok夹。比较2组的手术时间、热缺血时间、术中出血量、术后并发症情况。

38例患者手术均顺利完成，无中转开放或肾切除病例，2组的手术时间、术中出血量比较差异无统计学意义（P>0.05）。普通缝线组平均热缺血时间[（25±5）min]大于QuillTM缝线组[（15±4）min]，差异具有统计学意义（t=3.32，P=0.002）。2组均无术中并发症，普通缝线组1例因术后出血行选择性肾动脉栓塞，1例因漏尿留置D-J管。QuillTM缝线组术后无出血、漏尿等并发症。

倒刺缝合在腹腔镜肾部分切除术中应用安全、有效，可减少平均热缺血时间及术后并发症的发生率。

To investigate the clinical application of QuillTM self-retaining system in patients undergoing laparoscopic partial nephrectomy.

A retrospective analysis was conducted on the clinical data of 38 patients with renal neoplasms undergoing laparoscopic partial nephrectomy, who were admitted to the People's Hospital of Tibet Autonomous Region from June 2015 to January 2020. According to the suture used for renorrhaphy, the patients were divided into two groups. Vicryl suture was used for renorrhaphy in 20 patients (group 1), and QuillTM was used in 18 patients (group 2). Renorrhaphy was performed in two layers for both groups. In group 2, 2-0 QuillTM was used to suture the deep wound bed, and the second outer layer renorrhaphy was performed with I-0 QuillTM in the same way. In group 1, the inner layer was sutured using 2-0 Monocryl suture by the same method mentioned above. A second outer layer was sutured with 1-0 absorbable suture across the wound. The operation time, warm ischemia time, intraoperative blood loss, and postoperative complications were compared between the two groups.

Renorrhaphy was successfully performed in all the 38 cases without conversion to open procedure or nephretomy. The estimated blood loss and average operation time did not differ significantly between the two groups (P>0.05), although warm ischemic time was significantly shorter in the QuillTM group than in the Vicryl group [15±4) min vs (25±5) min, t=3.32, P=0.002]. There were no intraoperative complications in either group. One patient in the Vicryl suture group underwent selective renal artery embolization due to postoperative hemorrhage, and one patient was left with a D-J tube for leaking urine. There was no postoperative complication in the QuillTM suture group.

QuillTM is safe and effective for renorrhaphy in laparoscopic partial nephrectomy. The suture time, warm ischemic time, and the incidence of postoperative complications can be reduced by using the QuillTM suture in operation.