Gabriele Raimondo, Conte Marco, Izzo Luciano, Basso Luigi
Department of Surgery P. Valdoni, University of Rome La Sapienza Medical School-Policlinico Umberto I, Viale del Policlinico, Roma, Italy.
J Obstet Gynaecol Res. 2010 Oct;36(5):944-9. doi: 10.1111/j.1447-0756.2010.01283.x. Epub 2010 Aug 17.
Hernias of the abdominal wall occurring during pregnancy are usually treated a few weeks after delivery. The aim of this study was to retrospectively evaluate the clinical outcome of inguinal or umbilical hernioplasty performed at the time of the cesarean section, and to compare the outcome of this group with a control population, who received a cesarean section alone.
MATERIAL & METHODS: We reviewed 28 women who developed an inguinal or umbilical hernia during pregnancy from January 1, 2000 to December 31, 2007 and who received a combined cesarean section and hernia repair, and we compared this group with 100 women (controls) who only received a cesarean section.
In the group of women who received a combined cesarean section and inguinal or umbilical hernia repair, median age was 23.8 years and hospital stay ranged from 3 to 5 days (versus 3-4 days for cesarean sections alone). The time employed for the combined surgical procedure was of 50 ± 7 min and 70 ± 4 min, respectively, for umbilical and inguinal hernia (versus 37.4 ± 12.6 min for cesarean sections alone). No complication was recorded during the perinatal and follow-up periods, and no recurrences were observed.
Our analysis suggests that cesarean section and hernia repair, performed in one session, avoids need for readmission to hospital, is safe, effective, and well accepted. It neither increases the complication rate nor prolongs the hospital stay, with clear advantages for both the patients and the hospital budget.
孕期发生的腹壁疝通常在分娩后几周进行治疗。本研究的目的是回顾性评估剖宫产时进行腹股沟或脐疝修补术的临床结局,并将该组患者的结局与仅接受剖宫产的对照组人群进行比较。
我们回顾了2000年1月1日至2007年12月31日期间孕期发生腹股沟或脐疝且接受剖宫产联合疝修补术的28名女性,并将该组与仅接受剖宫产的100名女性(对照组)进行比较。
在接受剖宫产联合腹股沟或脐疝修补术的女性组中,中位年龄为23.8岁,住院时间为3至5天(单纯剖宫产为3 - 4天)。脐疝和腹股沟疝联合手术所用时间分别为50±7分钟和70±4分钟(单纯剖宫产为37.4±12.6分钟)。围产期和随访期间未记录到并发症,也未观察到复发情况。
我们的分析表明,剖宫产和疝修补术一次完成,可避免再次入院,安全有效,且易于接受。它既不增加并发症发生率,也不延长住院时间,对患者和医院预算都有明显优势。