Antinori Armando, Moschella Francesca, Tomaiuolo Pasquina M C, Crucitti Antonio, La Greca Antonio, Maci Eliana, Magistrelli Paolo
Unità Operativa di Chirurgia Generale 2, Dipartimento di Scienze Chirurgiche, Policlinico Universitario A. Gemelli, UCSC Roma.
Chir Ital. 2008 May-Jun;60(3):409-17.
The application of laparoscopic principles to ventral or incisional hernia repair has recently been shown to be a safe and effective alternative to open procedures. In this study we analyzed our recent experience with laparoscopic incisional-ventral hernia repair. The outcomes of 75 consecutive patients (January 2002 to July 2006) who underwent laparoscopic repair for incisional-ventral hernia were reviewed. Patient's demographics, hernia parameters, and intraoperative and postoperative data were collected. Of the 75 patients, 44 were females and 31 males. Mean age was 59.1 yrs (range 29-80 yrs). Mean BMI was 25.9 (range 19.4-36.7). Twenty-one patients had primary ventral hernias while 54 patients had an incisional hernia. Fifty-three patients had a single defect and 22 patients multiple defects. In 45 cases the incisional hernia was a primary hernia; in 4 cases it was a first recurrence; in 2 cases a 2nd recurrence; and in 3 cases a 3rd recurrence. The mean defect size was 52,7 cm2 (range 4-432). Laparoscopic hernia repair was successfully performed in 71 cases (94.7%). The mean mesh size was 211 cm2 (range 63-694). Mean operating time was 101 min (range 50-220 min). The mean hospital stay was 4.7 days. The postoperative morbidity rate was 14%. After a mean follow-up of 24.6 months (range 7-56) the recurrence rate was 7% (5/71). Laparoscopic repair of incisional-ventral hernias seems to be safe and effective. Medium-term outcomes were promising with a relatively low rate of conversion to open surgery, a low complication rate and a low risk of recurrence.
腹腔镜技术应用于腹侧或切口疝修补术，近来已被证明是一种安全有效的开放性手术替代方案。在本研究中，我们分析了近期腹腔镜切口-腹侧疝修补术的经验。回顾了75例（2002年1月至2006年7月）接受腹腔镜切口-腹侧疝修补术患者的结果。收集了患者的人口统计学资料、疝参数以及术中、术后数据。75例患者中，女性44例，男性31例。平均年龄59.1岁（范围29 - 80岁）。平均体重指数为25.9（范围19.4 - 36.7）。21例患者为原发性腹侧疝，54例患者为切口疝。53例患者有单个缺损，22例患者有多个缺损。45例切口疝为原发性疝；4例为首次复发；2例为第二次复发；3例为第三次复发。平均缺损面积为52.7 cm²（范围4 - 432）。71例（94.7%）成功进行了腹腔镜疝修补术。平均补片面积为211 cm²（范围63 - 694）。平均手术时间为101分钟（范围50 - 220分钟）。平均住院时间为4.7天。术后发病率为14%。平均随访24.6个月（范围7 - 56个月）后，复发率为7%（5/71）。腹腔镜切口-腹侧疝修补术似乎是安全有效的。中期结果令人满意，转为开放性手术的比例相对较低，并发症发生率低，复发风险低。
