Ferranti Fabrizio, Passa Giuseppe, Stefanuto Alberto, Quintiliani Alberto
Division of General Surgery, San Paolo Hospital, ASL RM/F Civitavecchia (Roma).
Chir Ital. 2008 Mar-Apr;60(2):249-55.
Conventional repair of incisional hernia is associated with significant complications and a high recurrence rate (30-50%). The laparoscopic approach offers an effective alternative and reduces the recurrences to less than 5%. The aim of this study was to review our experience with laparoscopic incisional hernia repair. Medical records of all patients who underwent laparoscopic incisional hernia repair from January 2002 to December 2006 were reviewed. Demographic and postoperative data were recorded. The study population consisted of 105 patients, 72 females (68.5%) and 33 males (31.5%); the mean age was 56 years (range: 17-83 years). The mean fascial defect size was 116.9 cm2 and the average mesh size used was 256 cm2. Operative time was 118 min and the average hospital stay was 5 days. An expanded polytetrafluoroethylene (ePTFE) prosthesis was used In all patients. Perioperative complications occurred in 33 patients (31.4%) including seroma, cellulitis at the trocar site and prolonged ileus. During the follow-up there were 3 hernia recurrences (2.8%). Our study shows that laparoscopic incisional hernia repair resulted in a moderate rate of perioperative complications, a short hospital stay and a low recurrence rate. Hence the laparoscopic technique should be considered an effective and safe alternative to conventional incisional hernia repair.
传统的切口疝修补术会引发严重并发症且复发率较高(30%-50%)。腹腔镜手术方法提供了一种有效的替代方案,可将复发率降低至5%以下。本研究的目的是回顾我们在腹腔镜切口疝修补术方面的经验。对2002年1月至2006年12月期间所有接受腹腔镜切口疝修补术的患者的病历进行了回顾。记录了人口统计学和术后数据。研究人群包括105例患者,其中女性72例(68.5%),男性33例(31.5%);平均年龄为56岁(范围:17-83岁)。平均筋膜缺损大小为116.9平方厘米,所用平均补片大小为256平方厘米。手术时间为118分钟,平均住院时间为5天。所有患者均使用了膨化聚四氟乙烯(ePTFE)假体。33例患者(31.4%)出现围手术期并发症,包括血清肿、套管针部位蜂窝织炎和肠梗阻延长。在随访期间有3例疝复发(2.8%)。我们的研究表明,腹腔镜切口疝修补术导致围手术期并发症发生率中等、住院时间短且复发率低。因此,腹腔镜技术应被视为传统切口疝修补术的一种有效且安全的替代方法。