Palanivelu Chinnusamy, Rangarajan Muthukumaran, Senthilkumar Rangaswamy, John Suviraj, Madankumar Madhupalayam Velusamy
Department of Minimal Access Surgery, GEM Hospital, Coimbatore, India.
J Laparoendosc Adv Surg Tech A. 2007 Jun;17(3):331-4. doi: 10.1089/lap.2006.0087.
Herniation through drain sites is a rare but recognized complication of surgical drainage and are actually considered to be a type of incisional hernia. Incisional hernias form following surgery through the incision site or previous drain sites, or through laparoscopic trocar insertion sites.
In this paper, we present 13 such patients with incisional hernia of the main laparotomy wound and at the drain site, and 1 patient with an isolated drain-site hernia. A laparoscopic meshplasty with a simple suturing of the drain-site defect was performed.
Incisional hernias are reported to occur in approximately 4%-10% of patients following open surgical procedures. There are several studies that have proven the efficacy of laparoscopic repair of incisional hernias, when compared to open procedures. The main predisposing factor regarding incisional hernias is probably the presence of a sepsis during the previous laparotomy, which was why the drainage tube was kept in the first place.
The laparoscopic approach is useful for repairing the main incisional hernia, as well as drain-site hernias, simultaneously. We cut costs by avoiding tacking devices and use intracorporeal suturing instead.
经引流部位发生疝是手术引流一种罕见但已得到公认的并发症，实际上被视为切口疝的一种类型。切口疝在手术后通过切口部位、既往引流部位或腹腔镜套管针穿刺部位形成。
在本文中，我们介绍了13例主剖腹手术切口和引流部位发生切口疝的患者，以及1例孤立性引流部位疝患者。实施了腹腔镜补片成形术并对引流部位缺损进行了简单缝合。
据报道，开放性手术术后约4%-10%的患者会发生切口疝。与开放性手术相比，有多项研究证实了腹腔镜修复切口疝的有效性。切口疝的主要诱发因素可能是既往剖腹手术期间存在脓毒症，这也是当初留置引流管的原因。
腹腔镜手术方法对于同时修复主切口疝和引流部位疝很有用。我们通过避免使用固定装置并改用体内缝合来降低成本。
