Angele M K, Löhe F, Dietz J, Hernandez-Richter T, Jauch K W, Heiss M M
Chirurgische Klinik und Poliklinik, Klinikum Grosshadern, Ludwig-Maximilians Universität, München.
Zentralbl Chir. 2005 Jun;130(3):255-9. doi: 10.1055/s-2005-836526.
Tension-free incisional hernia repair using alloplastic material increasingly replaces conventional repair techniques. The aim of the present study was to evaluate the early and long-term complications as well as patients' satisfaction.
Laparoscopic hernia repair with intraperitoneal mesh implantation (PTFE) was performed on 28 patients at the Klinikum Grosshadern between 2000 and 2003 (16 males, 12 females, average age 61.2). Intra- and postoperative complications were registered retrospectively. In addition, 25 patients were evaluated for recurrence, postoperative pain and patient contentment (median follow-up 383 days).
A low complication rate was observed in our patient collective. One trocar bleeding occurred. 2 patients presented with wound hematoma. The recurrence rate was 8 % (2/25). 60 % of the patients were free of pain postoperatively. 88 % would once again choose the laparoscopic approach for incisional hernia repair.
The laparoscopic technique was associated with a low recurrence rate, a small rate of wound infections and high patient comfort. Thus, the laparoscopic approach for mesh implantation appears to be a safe and effective method for the treatment of incisional hernias. The efficiency of laparoscopic intraperitoneal mesh implantation, however, should be evaluated within a prospectively randomized multicenter trial.
使用异体材料的无张力切口疝修补术越来越多地取代了传统修补技术。本研究的目的是评估早期和长期并发症以及患者满意度。
2000年至2003年期间，在格罗斯哈登临床医院对28例患者进行了腹腔镜疝修补术并植入腹膜内补片（聚四氟乙烯）（16例男性，12例女性，平均年龄61.2岁）。对术中和术后并发症进行回顾性记录。此外，对25例患者进行了复发、术后疼痛和患者满意度评估（中位随访383天）。
在我们的患者群体中观察到低并发症发生率。发生1例套管针出血。2例患者出现伤口血肿。复发率为8%（2/25）。60%的患者术后无疼痛。88%的患者会再次选择腹腔镜方法进行切口疝修补。
腹腔镜技术与低复发率、低伤口感染率和高患者舒适度相关。因此，腹腔镜补片植入方法似乎是治疗切口疝的一种安全有效的方法。然而，腹腔镜腹膜内补片植入的有效性应在前瞻性随机多中心试验中进行评估。
