Objective To investigate the effects of unidirectional barbed suture on gastrointestinal hormones, pain and immune function in patients treated with laparoscopic repair of perforated gastroduodenal ulcer (PGDU).
Methods A total of 80 patients treated with laparoscopic PGDU repair were retrospectively selected, and divided into the unidirectional barbed suture group (unidirectional group) and common absorbable suture group (control group) according to different suture methods (40 cases each group). The levels of calcitonin gene-related peptide (CGRP), pepsinogen Ⅰ (PGⅠ), motilin (MTL) and gastrin (GAS) were compared between two groups. The Numerical Rating Scale (NRS) scores of pain, immune functions (CD3+, CD4+, CD8+ and CD4+/CD8+), surgery-related indicators (intraoperative blood loss, suture time, recovery of intestinal peristalsis and hospital stay), and occurrence of complications (intestinal obstruction, abdominal infection and incision infection) were compared between two groups.
Results There was no statistical significance in the levels of CGRP, PGⅠ, MTL and GAS before the operation between two groups (P ＞ 0.05). After 1 week of operation, the levels of CGRP, PGⅠ, MTL and GAS in two groups increased compared with those before the operation (P ＜ 0.05), and the levels of CGRP, PGⅠ, MTL and GAS in the unidirectional group were significantly higher than those in control group (P ＜ 0.01). There was no statistical significance in the NRS scores at different time points after surgery, immune function indicators before and after surgery, intraoperative blood loss and hospital stay between two groups (P ＞ 0.05). The suture time and intestinal peristalsis recovery time in the unidirectional group were significantly shorter than those in control group (P ＜ 0.01). The total incidence of complications in the unidirectional group was 5.00% (2/40), which was not statistically different from 7.50% (3/40) in the control group (P ＞ 0.05).
Conclusions Unidirectional barbed sutures in laparoscopic PGDU repair can further shorten the time of suture and intestinal peristalsis recovery, and is more effective in improving gastrointestinal hormone levels.
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