腹腔镜下腹壁巨大切口疝修补术的临床应用
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田文

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Clinical experience in repair of huge incisional hernia with mesh by laparoscopic technique
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    摘要:

    目的:探讨腹腔镜下应用补片修补巨大腹壁切口疝的手术方法及临床效果。
    方法:分析25例应用腹腔镜下补片修补腹壁巨大切口疝(腹壁缺损长径为12~25 cm,宽9~18 cm,缺损面积108~451 cm2)患者的临床资料。
    结果:21例(84.0 %)顺利完成腹腔镜下腹壁切口疝修补术,4例(16.0 %)因肠管与腹壁粘连紧密而中转开腹。手术时间78~186(平均95)min 。术后住院5~8 d,平均6.5 d。术后疼痛达3个月以上8例(32.0 %),经治疗后缓解;浆液肿9例(36 %)。 无切口感染和肠瘘发生;无手术死亡。全组患者随访6~25(平均11)个月,无切口疝复发。
    结论:腹腔镜下修补腹壁巨大切口疝是一种安全、有效的方法,对腹腔粘连重分离困难者应及时中转开腹。

    Abstract:

    Abstract:Objective:To investigate the technique and outcome of laparoscopic repair of huge ventral incisional hernia using mesh.
    Methods :The clinical data of 25 patients with huge incisional hernia(abdominal wall defects 12 to 25 cm in length size and 9 to 18 cm in horizontal size, defect area of 108~451 cm2) were analyzed.
    Results:Twenty-one patients(84 %) underwent hernia repair successfully, 4 cases (16 %) were converted to open operation because of extensive adhesions intraperitoneally. The operative time was 78~186 (average 95) min. Postoperative hospital stay was 5 ~8 (average 6.5) days. Eight patients (32 %) had prolonged pain over three months, and nine patients (36 %) had seroma. No death, intestinal fistula ,or infection occurred postoperatively.No recurrence occurred in any of the cases within 6 to 25 months(average eleven months) follow-up.
    Conclusions:The laparoscopic repair of huge incisional hernia using mesh is a new, safe and effective operation.If extensive dense adhesions interfere with dissection ,the procedure should be converted to open operation.

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田文, 马冰, 杜晓辉, 夏绍友, 肖西平, 李荣, 陈凛.腹腔镜下腹壁巨大切口疝修补术的临床应用[J].中国普通外科杂志,2007,16(12):5-115.
DOI:10.7659/j. issn.1005-6947.2007.12.005

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  • 在线发布日期: 2007-12-25