Garcea Giuseppe, Ngu Wee, Neal Christopher P, Robertson Gavin S
Department of Hepatobiliary and Pancreatic Surgery, Leicester Royal Infirmary, Leicester, UK.
Surg Laparosc Endosc Percutan Tech. 2012 Apr;22(2):131-5. doi: 10.1097/SLE.0b013e318247bd07.
Incisional hernia is a problematic complication of abdominal surgery and both late and early outcomes can be unsatisfactory. Laparoscopic repair has been gaining popularity for both incisional and ventral herniae. However, the perceived benefits have not been convincingly demonstrated by randomized-controlled studies or meta-analyses.
Case notes from 54 patients undergoing consecutive laparoscopic repairs of the abdominal wall hernia at a single center were reviewed. Demographic data, postoperative complications, length of stay, and recurrence rates were all recorded.
The majority of the patients had incisional hernia, with de novo ventral hernia comprising 7.4% of the total. Forty percent of patients had undergone at least 1 previous repair of their incisional hernia. The median recorded diameter of the hernia defect was 5 cm. No recurrences were recorded over a median follow-up of 26 months. Complications were all minor and included seroma formation, hematoma, and wound infection (n=5 patients). Median operative duration was 45 minutes and median length of stay postoperatively was 1 day.
The results compare well with those in the published literature and would support the continued use of laparoscopic incisional/ventral hernia repair. Any benefits from this approach, however, are likely to be operator dependent. As a result, all units undertaking such repairs should regularly review their results and compare them with the reported standard.
切口疝是腹部手术的一个棘手并发症，早期和晚期结局可能都不尽人意。腹腔镜修补术在切口疝和腹疝的治疗中越来越受欢迎。然而，随机对照研究或荟萃分析尚未令人信服地证明其预期益处。
回顾了一家单一中心连续接受腹壁疝腹腔镜修补术的54例患者的病历。记录了人口统计学数据、术后并发症、住院时间和复发率。
大多数患者患有切口疝，新发腹疝占总数的7.4%。40%的患者此前至少接受过1次切口疝修补术。记录的疝缺损中位直径为5厘米。在中位随访26个月期间未记录到复发情况。并发症均为轻微并发症，包括血清肿形成、血肿和伤口感染（5例患者）。中位手术时间为45分钟，术后中位住院时间为1天。
这些结果与已发表文献中的结果相比良好，支持继续使用腹腔镜切口疝/腹疝修补术。然而，这种方法的任何益处可能都取决于手术医生。因此，所有进行此类修补术的科室都应定期审查其结果，并与报告的标准进行比较。
