Uslu Hatim Y, Erkek Ayhan B, Cakmak Atil, Kepenekci Ilknur, Sozener Ulas, Kocaay Firat A, Turkcapar Ahmet G, Kuterdem Ercument
Department of General Surgery, Ankara University, School of Medicine, Ankara, Turkey.
J Laparoendosc Adv Surg Tech A. 2007 Oct;17(5):600-3. doi: 10.1089/lap.2006.0182.
The aim of this study was to elucidate the influence of pre and perioperative factors on the development of trocar site hernia after a laparoscopic cholecystectomy procedure.
A total of 776 patients who underwent a laparoscopic cholecystectomy procedure in our Department of General Surgery between 1999 and 2004 were assigned as the study group. The control group included patients without trocar site hernias after a cholecystectomy. The effect of five variables, including gender, age, body mass index (BMI), operation duration, and the type of cholecystitis on the development of a trocar site hernia after a laparoscopic cholecystectomy was assessed by univariable and multivariable models.
In the univariate analysis, female gender (P = 0.021), older age (P < 0.001), higher BMI at the time of surgery (P < 0.001), and an increased duration of surgery (P < 0.001) have been found to increase the likelihood of a trocar site hernia formation. However, in the multivariable model, the gender was not a significant variable to influence the development of this complication.
The development of a postoperative trocar site hernia may be prevented by the closure of 10-mm trocar sites in patients who are older than 60 years, obese, and who have a longer duration of operation.
本研究旨在阐明术前及围手术期因素对腹腔镜胆囊切除术后套管针穿刺部位疝形成的影响。
将1999年至2004年间在我院普通外科接受腹腔镜胆囊切除术的776例患者作为研究组。对照组包括胆囊切除术后无套管针穿刺部位疝的患者。通过单变量和多变量模型评估性别、年龄、体重指数（BMI）、手术时长和胆囊炎类型这五个变量对腹腔镜胆囊切除术后套管针穿刺部位疝形成的影响。
在单变量分析中，发现女性（P = 0.021）、年龄较大（P < 0.001）、手术时较高的BMI（P < 0.001）以及手术时间延长（P < 0.001）会增加套管针穿刺部位疝形成的可能性。然而，在多变量模型中，性别并非影响该并发症发生的显著变量。
对于年龄大于60岁、肥胖且手术时间较长的患者，关闭10毫米套管针穿刺部位可预防术后套管针穿刺部位疝的发生。
