内镜与开放型组件分离术在复杂腹壁重建中的应用比较。

Endoscopic versus open component separation in complex abdominal wall reconstruction.

机构信息

Department of General Surgery, University Hospitals Case Medical Center, 11100 Euclid Ave., Mail Stop 5047, Room 7110, Cleveland, OH 44106-5047, USA.

出版信息

Am J Surg. 2010 Mar;199(3):342-6; discussion 346-7. doi: 10.1016/j.amjsurg.2009.09.015.

DOI:10.1016/j.amjsurg.2009.09.015

PMID:20226907

Abstract

BACKGROUND

Open component separation has a high wound complication rate. Newer endoscopic approaches are described with no comparative trials.

METHODS

A retrospective review (2005-2009) of patients undergoing open or endoscopic component separation was performed.

RESULTS

Forty-four cases were identified (22 endoscopic; 22 open). All perioperative variables were the same except age (65 open vs 55 endoscopic; P<.05). Hospital length of stay was 11 days in the open group versus 8 days in the endoscopic group (P=.09). Wound complications were 52% in the open group versus 27% in the endoscopic group (P=.09). Wound-related interventions occurred in 45% of the open group and 33% of the endoscopic group. Hernia recurrences rates were similar (open, 32%; endoscopic, 27%; P=.99).

CONCLUSIONS

Open and endoscopic components separation have similar rates of recurrence. The endoscopic group had shorter lengths of stay and less major wound complications. The endoscopic approach may be the ideal technique for complex abdominal wall reconstruction.

摘要

背景

开放式组件分离的伤口并发症发生率较高。新型内镜方法已被描述，但尚无对照试验。

方法

对 2005 年至 2009 年期间接受开放式或内镜式组件分离的患者进行回顾性研究。

结果

共确定了 44 例病例（22 例内镜式；22 例开放式）。除年龄（开放式 65 例，内镜式 55 例；P<.05）外，所有围手术期变量均相同。开放式组的住院时间为 11 天，而内镜式组为 8 天（P=.09）。开放式组的伤口并发症发生率为 52%，而内镜式组为 27%（P=.09）。开放式组中有 45%的患者需要进行与伤口相关的干预，而内镜式组中有 33%的患者需要进行干预。疝复发率相似（开放式为 32%；内镜式为 27%；P=.99）。