腹腔镜切口疝修补术在肝移植后是可行和安全的。
Laparoscopic incisional hernia repair is feasible and safe after liver transplantation.
机构信息
Department of Visceral Surgery and Medicine, Inselspital University Hospital Bern and University Bern, CH-3010 Bern, Switzerland.
出版信息
Surg Endosc. 2010 Jun;24(6):1451-5. doi: 10.1007/s00464-009-0799-2. Epub 2009 Dec 29.
BACKGROUND
Incisional hernia is a common complication after liver transplantation. The current study evaluated incidence and risk factors for incisional hernia and compared laparoscopic and open hernia repair in terms of feasibility and outcome.
METHODS
A cohort of 225 patients was prospectively investigated. The median follow-up period was 61 months (range, 6-186 months). The study cohort had 31 patients who underwent open repair and 13 who underwent laparoscopic repair.
RESULTS
Incisional hernia, found in 57 patients (25%), had occurred after a median of 17 months (range, 5-138 months). The significant risk factors were male gender (p = 0.001) and body mass index (BMI) greater than 25 kg/m(2) (p = 0.002). A trend toward a lower recurrence rate (15% vs 35%; p = 0.28) and fewer surgical complications (15% vs 19%; p = 0.99) was found in the laparoscopic group.
CONCLUSIONS
Incisional hernia is a frequent complication after liver transplantation. Associated risk factors are male gender and a BMI greater than 25 kg/m(2). Laparoscopic hernia repair for such patients is feasible and safe.
背景
切口疝是肝移植后的一种常见并发症。本研究评估了切口疝的发生率和危险因素，并比较了腹腔镜和开放式疝修补术在可行性和结果方面的差异。
方法
前瞻性调查了 225 例患者。中位随访时间为 61 个月（范围 6-186 个月）。研究队列中有 31 例患者接受了开放式修复，13 例接受了腹腔镜修复。
结果
57 例（25%）患者发生切口疝，中位时间为 17 个月（范围 5-138 个月）。显著的危险因素是男性（p=0.001）和 BMI 大于 25kg/m²（p=0.002）。腹腔镜组的复发率（15%比 35%；p=0.28）和手术并发症发生率（15%比 19%；p=0.99）较低。
结论
切口疝是肝移植后的常见并发症。相关的危险因素是男性和 BMI 大于 25kg/m²。腹腔镜疝修补术对于此类患者是可行和安全的。
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