Tessier Deron J, Swain James M, Harold Kristi L
Department of Surgery, Mayo Clinic Scottsdale, Scottsdale, 13400 E. Shea Blvd, Scottsdale, AZ 85259, USA.
Hernia. 2006 Mar;10(1):53-7. doi: 10.1007/s10029-005-0033-7. Epub 2006 Feb 23.
The published recurrence rate after laparoscopic ventral hernia repair is much less than the rate of recurrence via the open approach. Studies have demonstrated the safety and efficacy of this procedure but have had relatively young patient populations. We present our experience in a significantly older population. A retrospective chart review of all patients undergoing a laparoscopic ventral hernia repair at our institution from May 2000 to September 2004 was performed. Data extracted from charts included demographics, number and type of previous abdominal operations, number of previous hernia repairs, defect and mesh size, postoperative complications, and follow-up. Ninety-seven patients underwent laparoscopic ventral hernia repair (50 men and 47 women). The mean age was 68.5 years (37-85 years) with 78% of patients over the age of 60. Patients had undergone a mean of 2.1 prior abdominal operations. Thirty-five (36%) patients had undergone a mean of 1.8 previous open hernia repairs; 54% with mesh. The mean length of stay was 3.4 days (0-31 days). Thirty-three minor complications occurred in 27 patients. Six major complications occurred in five patients. Three patients required reoperation. Thirty-one percent of patients complained of pain at a transabdominal suture site 6 weeks after surgery. Nine percent of patients had seromas lasting longer than 6 weeks. Two recurrences occurred during follow-up and two patients required mesh removal. There were no deaths. Laparoscopic ventral hernia repair can be performed safely in patients regardless of age. Length of stay and overall complications are not affected by age. Long-term follow-up is necessary to evaluate the effectiveness of LVHR in this patient population.
腹腔镜下腹疝修补术后已公布的复发率远低于开放手术的复发率。研究已证实该手术的安全性和有效性，但研究对象的患者群体相对年轻。我们介绍在年龄较大患者群体中的经验。对2000年5月至2004年9月在我院接受腹腔镜下腹疝修补术的所有患者进行回顾性病历审查。从病历中提取的数据包括人口统计学资料、既往腹部手术的次数和类型、既往疝修补术的次数、缺损和补片大小、术后并发症及随访情况。97例患者接受了腹腔镜下腹疝修补术（50例男性，47例女性）。平均年龄为68.5岁（37 - 85岁），78%的患者年龄超过60岁。患者平均既往接受过2.1次腹部手术。35例（36%）患者平均既往接受过1.8次开放疝修补术；其中54%使用了补片。平均住院时间为3.4天（0 - 31天）。27例患者出现33例轻微并发症。5例患者出现6例严重并发症。3例患者需要再次手术。31%的患者术后6周时经腹缝合部位疼痛。9%的患者血清肿持续时间超过6周。随访期间出现2例复发，2例患者需要取出补片。无死亡病例。无论年龄大小，患者均可安全地进行腹腔镜下腹疝修补术。住院时间和总体并发症不受年龄影响。需要长期随访以评估该患者群体中腹腔镜下腹疝修补术的有效性。
