Moreno-Egea Alfredo, Cartagena Joaquin, Vicente Juan Pablo, Carrillo Andres, Aguayo Jose Luis
Abdominal Wall and Hernia Service, J.Ma. Morales Meseguer Hospital, Murcia, Spain.
Surg Laparosc Endosc Percutan Tech. 2008 Jun;18(3):267-71. doi: 10.1097/SLE.0b013e31816fef2b.
Findings have shown that laparoscopic incisional hernia repair is superior to conventional open techniques. The objective of the current study was to evaluate the results of laparoscopic surgery on incisional hernias in an outpatient surgery unit in a university hospital.
Data were gathered prospectively for all laparoscopic incisional hernia repairs from January 1997 to December 2006. A total of 127 patients were operated in an outpatient surgery unit. The patients' clinical features, hernia type, intraoperative and postoperative complications, and reasons for hospital admission are studied.
None of the patients required readmission to hospital, 15 had no need for analgesic treatment (11.8%) and the mean requirement was 6 days. The mean time of return to normal activity was less than 10 days and all the patients expressed their satisfaction with the procedure they received. During follow-up we detected 5 recurrences (4.4%). The statistical study showed no significant differences between the hospitalized patients and those treated on an ambulatory basis with regard to morbidity and recurrence rate (P<0.05). We do find a lower intraoperative and early postoperative (<30 d) complication rate in favor of the ambulatory patients (P<0.001).
Laparoscopic repair of incisional hernias can be performed as a highly efficient ambulatory procedure with igual morbidity and recurrences than hospitalized patients.
研究结果表明,腹腔镜切口疝修补术优于传统的开放技术。本研究的目的是评估在大学医院门诊手术单元进行腹腔镜手术治疗切口疝的效果。
前瞻性收集1997年1月至2006年12月期间所有腹腔镜切口疝修补术的数据。共有127例患者在门诊手术单元接受手术。对患者的临床特征、疝类型、术中及术后并发症以及住院原因进行研究。
所有患者均无需再次入院,15例患者无需镇痛治疗(11.8%),平均镇痛需求为6天。恢复正常活动的平均时间少于10天,所有患者对所接受的手术表示满意。随访期间发现5例复发(4.4%)。统计学研究表明,住院患者和门诊治疗患者在发病率和复发率方面无显著差异(P<0.05)。我们确实发现门诊患者的术中及术后早期(<30天)并发症发生率较低(P<0.001)。
腹腔镜切口疝修补术可作为一种高效的门诊手术进行,其发病率和复发率与住院患者相同。