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切口疝修复手术:一项比较腹腔镜与开放技术的前瞻性研究

[Incisional hernia prosthetic surgery: a prospective study comparing laparoscopic and open techniques].

作者信息

Manigrasso A, Candioli S, Arcieri S, Palazzini G, Filippini A

机构信息

"Sapienza", Università di Roma, Azienda Policlinico Umberto l, Dipartimento di Scienze Chirurgiche, UOC Chirurgia Generale.

出版信息

G Chir. 2009 May;30(5):201-14.

Abstract

BACKGROUND

Incisional hernia is a common complication of abdominal surgery and it is often a source of long-term morbidity. Surgical treatment include many different techniques and up to today the choice may be difficult. The employment of prosthetic materials has contributed to a remarkable improvement in the results of this surgery. We performed a prospective study to compare the outcomes after laparoscopic and open incisional hernia repair.

PATIENTS AND METHODS

A total of 60 patients were assigned at random to two groups to be operated for median incisional hernia with mesh. Of these, 30 underwent laparoscopic repair and 30 open repair performed by Rives-Stoppa technique. Early and long-term outcomes were analyzed by a median follow-up of 45 months (range 31-78). Statistical analysis was done to asses differences between the groups.

RESULTS

Both groups were homogeneus in terms of patient age, sex, body mass index, American Society of Anesthesiologists score and incisional hernia features. Laparoscopic repair is associated with a significantly lower incidence of wound infections, shorter operative time and hospitalization and faster return to work. The recurrence rate was similar between the two groups.

CONCLUSION

In our experience laparoscopic incisional hernia repair appear to be a safe, feasible and effective alternative to Rives-Stoppa technique.

摘要

背景

切口疝是腹部手术的常见并发症,且常常是长期发病的根源。手术治疗包括多种不同技术,直至如今选择起来可能仍很困难。人工合成材料的使用已使该手术的效果有了显著改善。我们进行了一项前瞻性研究,以比较腹腔镜下和开放性切口疝修补术后的结果。

患者与方法

总共60例患者被随机分为两组,接受使用补片的正中切口疝修补手术。其中,30例行腹腔镜修补术,30例行Rives-Stoppa技术的开放性修补术。通过中位随访45个月(范围31 - 78个月)分析早期和长期结果。进行统计学分析以评估两组之间的差异。

结果

两组在患者年龄、性别、体重指数、美国麻醉医师协会评分以及切口疝特征方面均具有同质性。腹腔镜修补术的伤口感染发生率显著较低,手术时间和住院时间较短,恢复工作更快。两组之间的复发率相似。

结论

根据我们的经验,腹腔镜下切口疝修补术似乎是Rives-Stoppa技术安全、可行且有效的替代方法。

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