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腹腔镜下腹壁和切口疝修补术后慢性疼痛的经腹缝线拆除术

Removal of transabdominal sutures for chronic pain after laparoscopic ventral and incisional hernia repair.

作者信息

Wassenaar Eelco B, Raymakers Johan T F J, Rakic Srdjan

机构信息

Department of Surgery, Twenteborg Hospital, Almelo, The Netherlands.

出版信息

Surg Laparosc Endosc Percutan Tech. 2007 Dec;17(6):514-6. doi: 10.1097/SLE.0b013e3181462b9e.

Abstract

Some patients who have undergone laparoscopic repair of ventral and incisional hernia have persistent postoperative pain, assumed to be caused by the presence of transabdominal sutures (TAS). We investigated whether removal of these sutures relieves discomfort. Of 375 patients who underwent laparoscopic repair of ventral and incisional hernia, 6 patients (1.6%) had persistent pain resistant to conservative therapy. These patients underwent relaparoscopy and removal of TAS at all apparent pain sites. Postoperatively, 3 patients had complete pain relief. Two patients had some improvement but moderate, less localized, pain remained. The sixth patient experienced no change at all. Removal of TAS deemed responsible for pain may occasionally provide relief, but the results of removal seem unpredictable and less effective than previously assumed.

摘要

一些接受腹腔镜下腹壁和切口疝修补术的患者术后仍持续疼痛,推测是由经腹缝线(TAS)的存在所致。我们研究了移除这些缝线是否能缓解不适。在375例接受腹腔镜下腹壁和切口疝修补术的患者中,6例(1.6%)存在对保守治疗无效的持续性疼痛。这些患者接受了再次腹腔镜检查,并在所有明显的疼痛部位移除了TAS。术后,3例患者疼痛完全缓解。2例患者有一定改善,但仍有中度、范围较小的疼痛。第六例患者则毫无变化。移除被认为是疼痛原因的TAS偶尔可能会缓解疼痛,但移除的效果似乎不可预测,且不如之前设想的有效。

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