Verbo A, Petito L, Pedretti G, Manno A, Rizzo G, Masi A, Coco C
Dipartimento di Scienze Chirurgiche, Università Cattolica del Sacro Cuore di Roma, Rome.
Minerva Chir. 2005 Aug;60(4):257-66.
Incisional hernias are one of the most frequent complications of open abdominal surgery. Historically, the best results have been obtained with the open rives-stoppa approach. This is done by fixing a large piece of prosthetic mesh behind the rectus muscle. Laparoscopic approach allows similar mesh placement with minimal dissection and lower recurrence rate compared to the open mesh repair.
Between October 2001 to September 2003, 75 consecutive patients were scheduled to undergo laparoscopic incisional hernia repair with ePTFE mesh (Gore-Tex Dualmesh Plus). Postoperative complications were recorded and analysed.
Most were obese affected by multiple wall defects Conversion to open surgery was required in 1 case Postoperative complications occurred 13.3%. Recurrence occurred in one only case.
The key to the success of this procedure is avoidance of complications. The laparoscopic approach is safe, effective and relatively complication-free option in the management of patients presenting with a first time or recurrent incisional hernia and recommended as the treatment of choice.
切口疝是开腹手术最常见的并发症之一。从历史上看，开放的里夫斯 - 斯托帕手术方法取得了最佳效果。该方法是通过在腹直肌后方固定一大块人工合成补片来完成的。与开放式补片修补术相比，腹腔镜手术方法能够以最少的解剖操作实现类似的补片放置，且复发率更低。
在2001年10月至2003年9月期间，连续75例患者计划接受使用ePTFE补片（戈尔泰克斯双网加强型）的腹腔镜切口疝修补术。记录并分析术后并发症。
大多数患者为肥胖者，存在多处腹壁缺损。1例患者需要转为开放手术。术后并发症发生率为13.3%。仅1例出现复发。
该手术成功的关键在于避免并发症。对于首次出现或复发性切口疝的患者，腹腔镜手术方法是一种安全、有效且相对无并发症的选择，推荐作为首选治疗方法。
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