Jeong Gui-Ae, Cho Gyu-Seok, Kim Hyung-Chul, Shin Eun-Jin, Song Ok-Pyung
Department of Surgery, College of Medicine, Soonchunhyang University, Bucheon, Korea.
Surg Laparosc Endosc Percutan Tech. 2008 Dec;18(6):611-5. doi: 10.1097/SLE.0b013e3181825733.
Paraduodenal hernia is a congenital internal hernia caused by abnormal retroperitoneal fixation of the intestinal mesentery. The management of paraduodenal hernia consists of reduction of the herniated intestine and repair of the defect. Recently, laparoscopic surgery has been increasingly performed in abdominal procedures. To evaluate the feasibility and efficacy of laparoscopic repair of paraduodenal hernia, we present our experience in 2 cases of laparoscopic repair, compared with 3 other cases treated with conventional open repair; all 5 cases were successfully treated. All patients had symptoms of intestinal obstruction and were diagnosed by preoperative abdominal computed tomography. Two cases were right-sided hernias, and 3 cases were left sided. Among them, 2 patients with left-sided paraduodenal hernia underwent laparoscopic reduction (LR group) of the herniated small bowel, and the other 3 cases underwent open reduction (OR group). In the LR group, the duration of hospital stay, time to first flatus, and time to first intake of a soft diet were shorter than in the OR group. Thus, with an accurate preoperative diagnosis of paraduodenal hernia, laparoscopic surgery may be a feasible and efficient procedure, with good postoperative outcomes.
十二指肠旁疝是一种由肠系膜腹膜后固定异常引起的先天性内疝。十二指肠旁疝的治疗包括将疝出的肠管复位并修复缺损。近年来,腹腔镜手术在腹部手术中的应用越来越广泛。为了评估腹腔镜修复十二指肠旁疝的可行性和疗效,我们介绍了2例腹腔镜修复的经验,并与另外3例接受传统开放修复的病例进行了比较;所有5例均成功治疗。所有患者均有肠梗阻症状,术前经腹部计算机断层扫描确诊。2例为右侧疝,3例为左侧疝。其中,2例左侧十二指肠旁疝患者接受了腹腔镜下疝出小肠复位术(LR组),另外3例接受了开放复位术(OR组)。LR组的住院时间、首次排气时间和首次进食软食时间均短于OR组。因此,术前准确诊断十二指肠旁疝,腹腔镜手术可能是一种可行且有效的手术方法,术后效果良好。