Losanoff J E, Richman B W, Jones J W
Department of Surgery M580 Health Sciences Center, University of Missouri-Columbia School of Medicine, One Hospital Drive, Columbia, MO 65212, USA..
Hernia. 2003 Dec;7(4):220-3. doi: 10.1007/s10029-003-0133-1. Epub 2003 Apr 10.
Only a few reports have been published describing necrotizing soft tissue infection (NSTI) following laparoscopic surgery; none identify trocar-site hernia as an etiologic factor. We present a case report and review of the literature. A 43-year-old previously healthy man underwent uneventful laparoscopic cholecystectomy. An unrecognized strangulated lateral trocar-site hernia resulted in fatal NSTI. A Medline database search (1966-2002) identifies ten detailed reports of NSTIs following laparoscopic surgery. Multiple risk factors were identified in almost all patients. The mortality rate was 20%. Patient survival from NSTI requires early recognition, aggressive surgical intervention, and intensive medical care. NSTI can occur following minimally invasive surgery, and physicians should maintain a high index of suspicion when patients begin to develop postoperative symptoms. Trocar-site hernia arises as another etiologic factor for NSTI in the domain of minimally invasive surgery.
仅有少数关于腹腔镜手术后发生坏死性软组织感染（NSTI）的报道发表；均未将套管针穿刺部位疝认定为病因。我们现报告一例病例并对文献进行综述。一名43岁既往健康的男性接受了顺利的腹腔镜胆囊切除术。一例未被识别的绞窄性外侧套管针穿刺部位疝导致了致命的NSTI。对Medline数据库（1966 - 2002年）的检索确定了10篇关于腹腔镜手术后NSTI的详细报道。几乎所有患者均发现了多种危险因素。死亡率为20%。NSTI患者的存活需要早期识别、积极的手术干预及重症医疗护理。NSTI可发生于微创手术后，当患者开始出现术后症状时，医生应保持高度怀疑。在微创手术领域，套管针穿刺部位疝成为NSTI的另一个病因。
