[腹腔镜胆囊切除术后套管针穿刺部位疝（TSH）：发病率、发病机制及预防——动物研究]
[Trocar site herniation (TSH) following laparoscopic cholecystectomy: incidence, pathogenesis, and prevention -- animal study].
作者信息
Gamal Eldin Mohamed, Szabó Györgyi, Metzger Péter, Furka István, Mikó Irén, Pető Katalin, Ferencz Andrea, Sándor József, Szentkereszty Zsolt, Sápi Péter, Wéber György
机构信息
Europ-Med Budaörs Egészségügyi Központ Egynapos Sebészeti Osztály 2040 Budaörs Kossuth Lajos u. 9.
出版信息
Magy Seb. 2013 Oct;66(5):270-3. doi: 10.1556/MaSeb.66.2013.5.7.
INTRODUCTION
In 1968 R. E. Fear first reported a trocar site hernia (TSH) in his large series on laparoscopy. Currently, the incidence of TSH is estimated to be 0.65-2.80%. Ports ≥10-mm are usually closed, but ports of the 5-mm trocars are always left open, which may lead to herniation.
MATERIAL AND METHODS
Authors guided teaching courses for hands-on animal laparoscopic cholecystectomy (LC) operations, where trainees performed LC-s on 60 animals. Two and four weeks following the operations the animals underwent second look laparoscopy to detect adhesion formation.
RESULTS
Trocar site herniation was observed, and in 20% of the animals herniation was found. 70% of the hernias were situated in the 5-mm ports and 30% in the 10-mm ports.
CONCLUSION
Port sites should be closed to prevent the formation of TSH. Attention should be payed on the closure of 5-mm trocar sites as well.
引言
1968年，R. E. 费尔在其关于腹腔镜检查的大量系列研究中首次报告了套管针穿刺部位疝（TSH）。目前，TSH的发生率估计为0.65 - 2.80%。≥10毫米的端口通常会关闭，但5毫米套管针的端口总是敞开的，这可能导致疝形成。
材料与方法
作者指导了实践动物腹腔镜胆囊切除术（LC）操作的教学课程，学员们对60只动物进行了LC手术。术后两周和四周，对动物进行二次腹腔镜检查以检测粘连形成。
结果
观察到套管针穿刺部位疝，在20%的动物中发现了疝。70%的疝位于5毫米端口，30%位于10毫米端口。
结论
应关闭端口部位以预防TSH的形成。对于5毫米套管针穿刺部位的关闭也应予以关注。
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