腹腔镜下腹直肌横断及腹壁下深动脉穿支皮瓣供区疝修补术
Laparoscopic mesh repair of transverse rectus abdominus muscle and deep inferior epigastric flap harvest site hernias.
作者信息
Ravipati Nagesh B, Pockaj Barbara A, Harold Kristi L
机构信息
Department of Surgery, Mayo Clinic, Scottsdale, AZ 85259, USA.
出版信息
Surg Laparosc Endosc Percutan Tech. 2007 Aug;17(4):345-8. doi: 10.1097/SLE.0b013e3180640d91.
INTRODUCTION
The transverse rectus abdominus muscle (TRAM) flap is one of the treatment options for breast reconstruction. TRAM flap reconstruction donor site herniation rates range from 1% to 8.8%. Traditionally, these hernias were treated by an open primary repair with or without the addition of onlay mesh. We report laparoscopic approach to treat TRAM and deep inferior epigastric perforator flap (DIEP) harvest site hernias with mesh.
CASES
We treated 5 patients, 4 from TRAM and 1 from DIEP flap harvest site hernias during the period of October 2003 to January 2006. Two of these patients underwent previous open mesh repair with recurrence. All of these patients underwent laparoscopic hernia repair using polytetrafluoroethylene dual mesh. Follow-up ranged 6 to 31 months without any recurrences.
CONCLUSIONS
Laparoscopic mesh repair of ventral hernias located at TRAM and DIEP flap harvest sites can be performed safely and with a low rate of recurrence.
引言
腹直肌横形肌皮瓣（TRAM瓣）是乳房重建的治疗选择之一。TRAM瓣重建供区疝发生率为1%至8.8%。传统上，这些疝通过开放一期修复治疗，可加用或不加用补片。我们报告采用腹腔镜方法加用补片治疗TRAM瓣和腹壁下深动脉穿支瓣（DIEP瓣）供区疝。
病例
2003年10月至2006年1月期间，我们治疗了5例患者，其中4例为TRAM瓣供区疝，1例为DIEP瓣供区疝。这些患者中有2例曾接受开放补片修复但复发。所有这些患者均采用聚四氟乙烯双层补片进行腹腔镜疝修补术。随访时间为6至31个月，无任何复发。
结论
位于TRAM瓣和DIEP瓣供区的腹疝采用腹腔镜补片修补术可安全进行，且复发率低。
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