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腹腔镜治疗腹疝:前瞻性评估

Laparoscopic treatment of ventral hernias: prospective evaluation.

作者信息

Bencini Lapo, Sanchez Luis Josè, Scatizzi Marco, Farsi Marco, Boffi Bernardo, Moretti Renato

机构信息

First Division of General Surgery and Transplantation, Careggi Hospital, Viale Morgagni 85, 50134 Florence, Italy.

出版信息

Surg Laparosc Endosc Percutan Tech. 2003 Feb;13(1):16-9. doi: 10.1097/00129689-200302000-00004.

Abstract

We describe 50 patients who recently underwent laparoscopic surgery. Early results, complications, and follow-up data were collected prospectively. Of 50 patients, 34 had an incisional hernia, whereas 16 had a primary defect. Three trocars were inserted. EndoShears or Ultracision was used for tissue manipulation. The prosthetic mesh used was an expanded polytetrafluoroethylene (ePTFE) mesh, inserted through the first trocar and fixed with a helicoidal stapler. Patients were followed-up in the outpatient clinic (mean, 14 months). Every operation was successfully completed, and mean operative time was 103 minutes. There were two small bowel injuries (4%) repaired by minilaparotomy. Postoperative pain was limited. Bowel movements, ambulation, and discharge were prompt. We noted 4 cases of urinary retention (8%), 8 seromas (16%), and 1 prolonged ileus, which resolved on day 5 spontaneously. Mean postoperative stay was 4 days. One patient was readmitted after 4 weeks because of incomplete obstruction, resolved conservatively. There has been only 1 recurrence (2%), 8 months after the operation. The technique appears safe and efficacious.

摘要

我们描述了50例近期接受腹腔镜手术的患者。前瞻性收集了早期结果、并发症及随访数据。50例患者中,34例有切口疝,16例有原发性缺损。插入了三个套管针。使用EndoShears或Ultracision进行组织操作。使用的人工补片是一种膨化聚四氟乙烯(ePTFE)补片,通过第一个套管针插入并用螺旋吻合器固定。患者在门诊接受随访(平均14个月)。每例手术均成功完成,平均手术时间为103分钟。有2例小肠损伤(4%)通过小切口剖腹术修复。术后疼痛较轻。肠道蠕动、下床活动和出院均较快。我们注意到4例尿潴留(8%)、8例血清肿(16%)和1例持续性肠梗阻,后者在第5天自行缓解。术后平均住院时间为4天。1例患者在4周后因不完全性肠梗阻再次入院,经保守治疗后缓解。术后仅1例复发(2%),发生在术后8个月。该技术似乎安全有效。

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