Lee Y K, Iqbal A, Vitamvas M, McBride C, Thompson J, Oleynikov D
Department of Surgery, University of Nebraska Medical Center, 983280 Nebraska Medical Center, Omaha, NE 68198-3280, USA.
Hernia. 2008 Jun;12(3):239-42. doi: 10.1007/s10029-007-0312-6. Epub 2007 Dec 8.
Ventral hernia is a common surgical condition occurring most often as a complication following abdominal surgery. Laparoscopic repair of a ventral hernia has been shown to be safe with low rates of complications, shortened length of stay, and low rates of early recurrence as compared to open surgery. Few studies have documented long-term outcomes of laparoscopic repair in elderly patients. The aim of this study is to report the long-term outcomes of laparoscopic ventral hernia repair with mesh in elderly patients.
This is a retrospective study in a university setting with IRB approval. Between the years 2000 and 2006, 117 patients underwent laparoscopic repair of ventral hernia with synthetic mesh. Data were collected using patient charts and radiographic reports. Patient variables included age, sex, size and content of hernia, size of mesh used, length of hospital stay (LHS), estimated blood loss (EBL), follow-up duration, and post-operative complications (PC) including infection, deep vein thrombosis, bleeding, and pulmonary embolism. The comparison was done between two different age groups (A <55 years old; B >or= 55 years old).
Current median (range) follow-up periods for group A (<55 years) and B (>or=55 years) were 57.5 and 53 months, respectively. Group A (63 patients) and B (54 patients) had same median LHS (1 day) and size of mesh utilized (285 cm(2)). For groups A and B, the percent female, and the percentages of recurrence, minimal EBL (<50 ml), and PC were 61.9 and 44.4; 1.6 and 3.7; 96.8 and 92.6; 4.8 and 12.9, respectively. Median hernia sizes for groups A and B were 55.1 and 54 cm(2). No significant differences were found for any of the above variables.
No significant difference was found in outcomes between younger versus older patients undergoing laparoscopic ventral hernia repair with mesh. Laparoscopic repair provides a durable and effective method of repairing a ventral hernia with low morbidity and mortality in the elderly population.
腹疝是一种常见的外科疾病，最常作为腹部手术后的并发症出现。与开放手术相比，腹腔镜修补腹疝已被证明是安全的，并发症发生率低，住院时间缩短，早期复发率低。很少有研究记录老年患者腹腔镜修补的长期结果。本研究的目的是报告老年患者腹腔镜腹疝修补术加补片的长期结果。
这是一项在大学环境中进行的回顾性研究，并获得了机构审查委员会的批准。在2000年至2006年期间，117例患者接受了腹腔镜腹疝修补术并使用了合成补片。使用患者病历和影像学报告收集数据。患者变量包括年龄、性别、疝的大小和内容物、所用补片的大小、住院时间（LHS）、估计失血量（EBL）、随访时间以及术后并发症（PC），包括感染、深静脉血栓形成、出血和肺栓塞。对两个不同年龄组（A<55岁；B≥55岁）进行了比较。
A组（<55岁）和B组（≥55岁）目前的中位（范围）随访期分别为5７.5个月和53个月。A组（63例患者）和B组（54例患者）的中位住院时间（1天）和所用补片大小（285平方厘米）相同。对于A组和B组，女性百分比、复发百分比、最小失血量（<50毫升）和术后并发症百分比分别为61.9%和44.4%；1.6%和3.7%；96.8%和92.6%；4.8%和12.9%。A组和B组的中位疝大小分别为55.1平方厘米和54平方厘米。上述任何变量均未发现显著差异。
在接受腹腔镜腹疝修补术加补片的年轻患者和老年患者之间，结果未发现显著差异。腹腔镜修补术为老年人群提供了一种持久有效的腹疝修补方法，发病率和死亡率低。
