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改良腹腔镜腹膜内补片植入术在复杂腹股沟疝手术中的应用

Modified laparoscopic intraperitoneal onlay mesh in complicated inguinal hernia surgery.

作者信息

Hyllegaard G M, Friis-Andersen H

机构信息

Surgical Department, Horsens Regional Hospital, 8700, Horsens, Denmark,

出版信息

Hernia. 2015 Jun;19(3):433-6. doi: 10.1007/s10029-014-1256-2. Epub 2014 Apr 29.

Abstract

PURPOSE

To analyse the recurrence rate and postoperative complications in inguinal hernia patients where the laparoscopic intraperitoneal onlay mesh technique (IPOM) was used due to preperitoneal fibrosis.

METHODS

Patients who had undergone inguinal herniotomy with the IPOM technique at Horsens Regional Hospital during the calender years of 2004 through 2010 filled out a questionnaire specific for recurrence and postoperative complications and had a clinical examination. Furthermore the medical records and national databases were analysed for reoperations for recurrent hernias.

RESULTS

37 patients (38 hernias) were operated. Two patients had a recurrent hernia (5 %), four patients (11 %) reported chronic pain and six patients (16 %) reported various bowel symptoms after the operation.

CONCLUSIONS

The optimal treatment of these relatively rare and complicated patients is still an issue of debate, but in the light of the present study it seems that the IPOM technique is equal to or has a better profile compared to Lichtenstein in terms of re-recurrence and chronic pain. We believe that the IPOM technique has a place in the treatment of these patients.

摘要

目的

分析因腹膜前纤维化而采用腹腔镜腹膜内补片植入技术(IPOM)治疗的腹股沟疝患者的复发率和术后并发症。

方法

2004年至2010年期间在霍森斯地区医院接受IPOM技术腹股沟疝修补术的患者填写了一份关于复发和术后并发症的特定问卷,并接受了临床检查。此外,还分析了病历和国家数据库中复发性疝再次手术的情况。

结果

37例患者(38处疝)接受了手术。2例患者出现复发性疝(5%),4例患者(11%)报告有慢性疼痛,6例患者(16%)报告术后有各种肠道症状。

结论

对于这些相对罕见且复杂的患者,最佳治疗方法仍是一个有争议的问题,但根据本研究,就再次复发和慢性疼痛而言,IPOM技术似乎与李金斯坦手术相当或具有更好的表现。我们认为IPOM技术在这些患者的治疗中占有一席之地。

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