Kwon Yoon-Hye, Choe Eun Kyung, Ryoo Seung-Bum, Kim Jeong-Ki, Park Kyu Joo
Am Surg. 2017 Feb 1;83(2):176-182.
Port site hernias are emerging as a problematic complication of laparoscopic surgery. The aim of this study was to elucidate the characteristics of port site hernias and determine the long-term outcomes based on the interval between primary surgery and hernia occurrence. Twenty-four patients were surgically treated for trocar site hernia between 1997 and 2013. The patients were grouped into early-onset group (EOG; less than one month) and late-onset group (LOG; more than one month) based on the interval between laparoscopic surgery and hernia onset. A retrospective analysis was performed. There were seven patients in the EOG and 17 patients in the LOG. The body mass index was significantly higher (P = 0.033) in the LOG. In the EOG, primary closure was performed, and there were no recurrences. In the LOG, mesh reinforcement was applied in 58.8 per cent of patients, and 29.4 per cent of patients had recurrences. This recurrence rate was higher than the recurrence rate after primary repair of incisional hernia after open laparotomy (P = 0.088). In conclusion, In the EOG, small bowel resection was more frequent, but once repaired, there were no recurrences. Although mesh reinforcement was applied in the LOG, the recurrence rate was not less than the EOG.
切口疝正逐渐成为腹腔镜手术的一个棘手并发症。本研究的目的是阐明切口疝的特征，并根据初次手术与疝发生之间的间隔时间确定其长期预后。1997年至2013年间，对24例因套管针部位疝接受手术治疗的患者进行了回顾性分析。根据腹腔镜手术与疝发病之间的间隔时间，将患者分为早发组（EOG；少于1个月）和晚发组（LOG；多于1个月）。早发组有7例患者，晚发组有17例患者。晚发组的体重指数显著更高（P = 0.033）。在早发组，采用了一期缝合，无复发病例。在晚发组，58.8%的患者应用了补片加强修补，29.4%的患者出现复发。该复发率高于开腹手术后切口疝一期修补后的复发率（P = 0.088）。总之，在早发组，小肠切除更为常见，但一旦修补，无复发情况。尽管晚发组应用了补片加强修补，但其复发率并不低于早发组。
