Schoenmaeckers Ernst, Stirler Vincent, Raymakers Johan, Rakic Srdjan
Department of Surgery, Hospital Group Twente (ZGT), Almelo, The Netherlands.
JSLS. 2012 Jan-Mar;16(1):85-8. doi: 10.4293/108680812X13291597716104.
There are no data on laparoscopic repair of ventral and incisional hernias (LRVIH) in fertile women who intend to have further pregnancies. A unique series is described of 8 women who got pregnant and gave birth after LRVIH.
Medical records of 875 consecutive patients who underwent LRVIH were reviewed. Women who gave birth after LRVIH were identified. At follow-up, patients answered a questionnaire on pain, discomfort, recurrence, and problems during pregnancy and delivery and underwent a physical examination.
Eight patients were identified; all agreed to inclusion. Four women received LRVIH for incisional hernia; 4 were operated on for primary ventral hernia. Median age at LRVIH was 29 years (range, 24 to 34). No postoperative complications occurred. Median time between LRVIH and delivery was 22.5 months (range, 12 to 44). Median follow-up after delivery was 23.5 months (range, 2 to 40). Five patients experienced a tearing pain in the area of hernia repair during the last months of pregnancy. This pain was not continually present and disappeared after delivery in all patients. All infants were born healthy at full term. Seven patients had a vaginal birth and one had a caesarean delivery. There were no major complications during pregnancy or delivery. At control examination, all patients were asymptomatic and, with one exception, without signs of recurrence. One patient had a swelling in the repaired area indicating either recurrence or mesh bulging. Being asymptomatic, she refused any further diagnostics.
LRVIH in fertile women who intend to have further pregnancies is an acceptable therapeutical option that causes no significant problems during pregnancy or delivery.
对于打算再次怀孕的育龄女性,尚无关于腹腔镜修复腹直肌旁疝和切口疝(LRVIH)的数据。本文描述了一组独特的病例,8名女性在接受LRVIH后怀孕并分娩。
回顾了875例连续接受LRVIH的患者的病历。确定了LRVIH后分娩的女性。在随访中,患者回答了关于疼痛、不适、复发以及妊娠和分娩期间问题的问卷,并接受了体格检查。
确定了8例患者;均同意纳入研究。4名女性因切口疝接受LRVIH;4名因原发性腹直肌旁疝接受手术。LRVIH时的中位年龄为29岁(范围24至34岁)。未发生术后并发症。LRVIH与分娩之间的中位时间为22.5个月(范围12至44个月)。分娩后的中位随访时间为23.5个月(范围2至40个月)。5名患者在妊娠最后几个月时疝修补部位出现撕裂样疼痛。这种疼痛并非持续存在,所有患者在分娩后均消失。所有婴儿均足月健康出生。7名患者经阴道分娩,1名患者剖宫产。妊娠或分娩期间无重大并发症。在对照检查中,所有患者均无症状,除1例患者外,均无复发迹象。1例患者修补区域有肿胀,提示复发或补片膨出。由于无症状,她拒绝进一步检查。
对于打算再次怀孕的育龄女性,LRVIH是一种可接受的治疗选择,在妊娠或分娩期间不会引起重大问题。