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腹腔镜腹疝修补术的即刻、早期和晚期发病率以及对复合补片的耐受性

Immediate, early, and late morbidity with laparoscopic ventral hernia repair and tolerance to composite mesh.

作者信息

Moreno-Egea Alfredo, Torralba José Antonio, Girela Enrique, Corral Miguel, Bento Marina, Cartagena Joaquin, Vicente Juan Pablo, Aguayo José Luis, Canteras Manuel

机构信息

Abdominal Wall Unit, Abdominal Surgery, J.M. Morales Meseguer Hospital, Murcia, Spain.

出版信息

Surg Laparosc Endosc Percutan Tech. 2004 Jun;14(3):130-5. doi: 10.1097/01.sle.0000129380.78278.56.

Abstract

The laparoscopic repair of ventral hernias is still a controversial therapeutic option, and little is known of its medium- and long-term morbidity. The purpose of the study is to evaluate the postoperative morbidity of laparoscopic ventral hernia repair and analyze the clinical factors that might be related to it. 86 consecutive patients who had ventral hernia and underwent endoscopic surgery in a Universitary teaching hospital. Epidemiological, clinical, postoperative complications, tolerance, aesthetic evaluation of the wall and recurrence rate are analyzed. The mean follow-up (100%) was 42 months (range: 1-5 years) and included clinical and ultrasonographic evaluation. The overall postoperative morbidity rate was 23.2%, with one case of mortality following a sepsis due to intestinal perforation; the rate of re-admissions and recurrences was 3.5%. Statistically significant relationships were shown between the complications and infra-umbilical location (P < 0.001), age over 60 years and female sex (P < 0.05). The dynamic ultrasound study showed 91% and 94% of the patients to be adhesion-free at 1 and 3 years respectively. Aesthetic assessment of the wall at 3 years showed persistent asymmetries in 5% of the patients and a 92% degree of personal satisfaction. The morbidity with laparoscopic ventral hernia repair is not negligible. The surgeon must know these complications and be able to treat them appropriately.

摘要

腹腔镜修补腹疝仍是一种存在争议的治疗选择,人们对其中长期发病率知之甚少。本研究的目的是评估腹腔镜腹疝修补术的术后发病率,并分析可能与之相关的临床因素。86例连续的腹疝患者在一家大学教学医院接受了内镜手术。分析了流行病学、临床情况、术后并发症、耐受性、腹壁美学评估和复发率。平均随访时间(100%)为42个月(范围:1 - 5年),包括临床和超声评估。术后总体发病率为23.2%,有1例因肠穿孔败血症死亡;再入院和复发率为3.5%。并发症与脐下位置(P < 0.001)、60岁以上年龄和女性性别(P < 0.05)之间存在统计学上的显著关系。动态超声研究显示,分别有91%和94%的患者在1年和3年时无粘连。3年时腹壁美学评估显示,5%的患者存在持续不对称,个人满意度为92%。腹腔镜腹疝修补术的发病率不可忽视。外科医生必须了解这些并发症并能够进行适当治疗。

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