经脐切口会增加腹腔镜前切除术取出部位的切口疝发生率吗？
Does transumbilical incision increase incisional hernia at the extraction site of laparoscopic anterior resection?
作者信息
Morita Yohei, Yamaguchi Shigeki, Ishii Toshimasa, Tashiro Jo, Kondo Haruka, Suzuki Asami, Hara Kiyoka, Koyama Isamu
机构信息
Department of Gastroenterological Surgery, Saitama Medical University International Medical Center, 1397-1, Yamane, Hidaka, Saitama 350-1298, Japan.
Department of Gastroenterological Surgery, Saitama Medical University International Medical Center, 1397-1, Yamane, Hidaka, Saitama 350-1298, Japan.
出版信息
Am J Surg. 2015 Jun;209(6):1048-52. doi: 10.1016/j.amjsurg.2014.06.023. Epub 2014 Aug 7.
BACKGROUND
It is unclear whether transumbilical incision for laparoscopic colectomy has a risk of incisional hernia at the extraction site similar to left lower incision.
METHODS
Consecutive patients who underwent laparoscopic sigmoid plus high and low anterior resection between August 2008 and February 2011 were included in the study. Incision for specimen extraction was changed from left lower to transumbilical incision in February 2010. The main outcome was the incidence of incisional hernia diagnosed by computed tomography.
RESULTS
One hundred and eighty-six patients underwent laparoscopic anterior resection (94 transumbilical incisions and 92 left lower transverse incisions). Three percent of patients had an incisional hernia at the extraction site, and the incidence of this phenomenon was not significantly different between the 2 groups. Surgical wound infection was lower in the transumbilical incision group than in the left lower incision group.
CONCLUSIONS
Extraction site for transumbilical incision may not affect the risk of incisional hernia.
背景
腹腔镜结肠切除术的经脐切口在标本取出部位发生切口疝的风险是否与左下腹切口相似尚不清楚。
方法
纳入2008年8月至2011年2月期间连续接受腹腔镜乙状结肠切除术加高位和低位前切除术的患者。2010年2月，标本取出切口从左下腹改为经脐切口。主要结局是通过计算机断层扫描诊断的切口疝发生率。
结果
186例患者接受了腹腔镜前切除术（94例经脐切口和92例左下腹横切口）。3%的患者在标本取出部位发生切口疝，两组之间这种现象的发生率无显著差异。经脐切口组的手术伤口感染率低于左下腹切口组。
结论
经脐切口的标本取出部位可能不影响切口疝的风险。
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