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腹腔镜组件分离可减少术后伤口并发症,但不会改变复杂疝修补术后的复发率。

Laparoscopic component separation reduces postoperative wound complications but does not alter recurrence rates in complex hernia repairs.

机构信息

Department of Surgery, University of Louisville, 550 S Jackson Street, 2nd Floor ACB, Louisville, KY 40202, USA.

出版信息

Am J Surg. 2013 Dec;206(6):869-74; discussion 874-5. doi: 10.1016/j.amjsurg.2013.08.005. Epub 2013 Oct 7.

Abstract

BACKGROUND

The purpose of this study was to evaluate and compare the incidence of wound complications after laparoscopic component separation (LCS) vs open component separation (OCS) in patients with complex abdominal wall hernias.

METHODS

A retrospective review was performed of all patients who underwent LCS or OCS for repair of a complex abdominal wall hernia at a single institution between 2009 and 2011. Charts were reviewed to identify postoperative wound complications. A computed tomographic scan or physical examination was used for the determination of hernia recurrence. Categoric variables were compared using the Fisher exact test. Univariate and multivariate analyses were performed using linear and Cox regression. Recurrence rates were compared using log-rank tests (Kaplan-Meier method).

RESULTS

A total of 44 patients underwent LCS (n = 18) or OCS (n = 26). There was no statistically significant difference between categoric variables. Multivariate analysis using wound complications as the dependent variable showed a statistically significantly lower rate of wound complications in the LCS group.

CONCLUSIONS

LCS is associated with a lower rate of wound complications when compared with OCS but yields comparable recurrence rates.

摘要

背景

本研究旨在评估和比较腹腔镜下组件分离术(LCS)与开放式组件分离术(OCS)治疗复杂腹壁疝患者术后伤口并发症的发生率。

方法

对 2009 年至 2011 年期间在一家机构接受 LCS 或 OCS 治疗复杂腹壁疝的所有患者进行回顾性研究。通过查看图表来识别术后伤口并发症。使用计算机断层扫描或体格检查来确定疝复发。使用 Fisher 精确检验比较分类变量。使用线性和 Cox 回归进行单变量和多变量分析。使用对数秩检验(Kaplan-Meier 法)比较复发率。

结果

共 44 例患者接受了 LCS(n = 18)或 OCS(n = 26)。分类变量之间无统计学差异。使用伤口并发症作为因变量的多变量分析显示,LCS 组的伤口并发症发生率较低。

结论

与 OCS 相比,LCS 术后伤口并发症发生率较低,但复发率相当。

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