Antinori Armando, Moschella Francesca, Maci Eliana, Accetta Cristina, Nunziata Joseph, Magistrelli Paolo
Unità Operativa di Chirurgia Generale 2, Dipartimento di Scienze Chirurgiche, Policlinico Universitario "A. Gemelli" - UCSC, Roma.
Ann Ital Chir. 2008 Nov-Dec;79(6):435-9.
Umbilical and epigastric hernias are relatively frequent amounting to about 10% of all primary hernias. The aim of this study was to evaluate the efficacy and safety of laparoscopic primary ventral hernia repair.
From January 2002 through July 2007 a total of 23 consecutive patients were treated by laparoscopy for primary ventral hernia. Main demographics, intraoperative and postoperative data were collected.
There were 14 males and 9 females with a mean age of 53.1 yrs (range 28-70 yrs). Mean body mass index was 25.2 kg/m2 (range 19.4 - 35.2). Fifteen patients had an umbilical hernia, 6 patients had an epigastric hernia and 2 a Spigelian hernia. Mean defect size was 8,4 cm2 (range 1.7 - 81.6). Mean mesh size was 115.9 cm2 (range 62.8-310.8). Mean operating time was 76.1 min (range 50-130). Mean hospital stay was 3,4 days (range 2-8). The median postoperative pain score (evaluated by a visual analog scale - VAS) was 2 at day 1, 4 at day 3 and 1 at day 7. Morbidity rate was 4.3%. After a mean follow-up of 28.5 months none recurrences were observed.
Our study confirmed the feasibility of laparoscopic repair in terms of postoperative morbidity and recurrence rate. Thus laparoscopic primary ventral hernia repair should be considered an effective alternative to open techniques.
脐疝和上腹疝相对常见,约占所有原发性疝的10%。本研究旨在评估腹腔镜原发性腹疝修补术的疗效和安全性。
从2002年1月至2007年7月,共有23例连续的原发性腹疝患者接受了腹腔镜治疗。收集了主要人口统计学资料、术中及术后数据。
男性14例,女性9例,平均年龄53.1岁(范围28 - 70岁)。平均体重指数为25.2 kg/m²(范围19.4 - 35.2)。15例患者为脐疝,6例为上腹疝,2例为半月线疝。平均缺损面积为8.4 cm²(范围1.7 - 81.6)。平均补片面积为115.9 cm²(范围62.8 - 310.8)。平均手术时间为76.1分钟(范围50 - 130)。平均住院时间为3.4天(范围2 - 8)。术后第1天疼痛视觉模拟评分(VAS)中位数为2,第3天为4,第7天为1。发病率为4.3%。平均随访28.5个月后未观察到复发。
我们的研究证实了腹腔镜修补术在术后发病率和复发率方面的可行性。因此,腹腔镜原发性腹疝修补术应被视为开放手术的有效替代方法。