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腹腔镜治疗与开放手术治疗伴有补片的大型切口疝和腹壁疝的比较

Laparoscopic treatment vs open surgery in the solution of major incisional and abdominal wall hernias with mesh.

作者信息

Carbajo M A, Martín del Olmo J C, Blanco J I, de la Cuesta C, Toledano M, Martin F, Vaquero C, Inglada L

机构信息

Department of General Surgery, Medina del Campo Hospital, Carretera de Peñaranda km 1, 47400 Medina del Campo, Valladolid, Spain.

出版信息

Surg Endosc. 1999 Mar;13(3):250-2. doi: 10.1007/s004649900956.

Abstract

BACKGROUND

Despite being one of the most exact indications, laparoscopic treatment of eventrations and ventral hernias is barely known among the array of laparoscopic techniques.

METHODS

A total of 60 patients were assigned at random over a 3-year period to two homogeneous groups to be operated on for major ventral hernias with mesh. Half of them were operated upon laparoscopically and the rest with open surgery. Early and longer-term complications were analyzed, as were operative time and postoperative hospital stays.

RESULTS

The two groups were homogeneous in terms of demographic and clinical characteristics. The group that was operated on laparoscopically presented a lower rate of postoperative and longer-term complications; similarly, surgery time was significantly lower (p < 0.05). Hospitalization time was also significantly lower than in the group undergoing conventional open surgery (p < 0.05).

CONCLUSIONS

Laparoscopic treatment of postoperative eventration and primary ventral hernia reduces complications and relapse rates, eliminates reintervention through mesh infection, reduces operative time, and considerably shortens the hospital stay.

摘要

背景

尽管腹腔镜治疗膈膨出和腹疝是最确切的适应证之一,但在一系列腹腔镜技术中却鲜为人知。

方法

在3年时间里,共随机分配60例患者至两个同质组,接受使用补片的大型腹疝手术。其中一半接受腹腔镜手术,其余接受开放手术。分析早期和长期并发症、手术时间和术后住院时间。

结果

两组在人口统计学和临床特征方面同质。接受腹腔镜手术的组术后和长期并发症发生率较低;同样,手术时间显著更短(p < 0.05)。住院时间也显著低于接受传统开放手术的组(p < 0.05)。

结论

腹腔镜治疗术后膈膨出和原发性腹疝可降低并发症和复发率,消除因补片感染导致的再次干预,减少手术时间,并显著缩短住院时间。

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