The Safety and Usefulness of Synthetic Absorbable Monofilament, Glycoside-$\varepsilon$-caprolactonetrimethylene Carbonate Interpolymer, in Gastrointestinal Anastomosis and Closure

위장관문합 및 봉합 시 인공 흡수성 단사인 Glycoside-$\varepsilon$- caprolactone-trimethylene Carbonate 혼성중합체의 안정성 및 유용성

Purpose: Synthetic absorbable monofilaments offer excellent glide characteristics and cause minimal tissue trauma as a result of their smooth monofilament structure and gradual absorption within the healing tissues. For these reasons, these suture materials are commonly used in various surgical fields such as gastroenterology, urology, gynecology, and plastic surgery. The aim of this study was to evaluate the safety and usefulness of a new synthetic absorbable monofilament, Glycoside-..-caprolactone-trimethylene carbonate interpolymer (GCT), in gastrointestinal anastomosis and closure. Materials and Methods: We evaluated 55 gastrointestinal anastomoses and closures using GCT $MONOSYN^{R}$, B. Braun, Germany) in 47 patients who underwent gastric surgery between December 2001 and May 2002 at Seoul National University Hospital. Patient's characteristics, operative procedure, surgeon's opinion of handling properties of GCT, and suture-related complications were analyzed. Results: There were 34 males and 13 females (M:F= 2.6:1) with an average age of 54.2 years old. Forty-five cases of gastrointestinal anastomosis (20 gastrojejunostomies and 25 jejunojejunostomies) and 10 cases of intestinal closure (7 gastrostomy closures and 3 duodenal stump closures) were performed in 41 cases of stomach cancer, three of peptic ulcer disease, two of GIST, and one MALToma. The handling properties of GCT according to the criteria of knot breaking load, knot security, and placing property were always scored with 7 to 9 points (10=excellent, 1=very poor). Two cases of postoperative complications ($3.6\%$) were noted. One was a leak of the gastrojejunostomy site which was successfully managed conservatively, and the other was a stricture of the gastrojejunostomy site which was managed by reoperation (side-to-side jejunojejunostomy). Conclusion: GCT seems to be an applicable suture material for various gastrointestinal anastomoses and closures.