腹腔镜腹会阴切除术后经腹腔镜植入锥形补片修补会阴疝。
Laparoscopic repair with cone-shaped mesh implantation for perineal hernia occurred after laparoscopic abdominoperineal resection.
作者信息
Teramura Koichi, Watanabe Yusuke, Takeuchi Shintaro, Nakamura Fumitaka, Hirano Satoshi
机构信息
Department of Surgery, Teine Keijinkai Hospital, Sapporo, Japan.
Department of Surgery, Teine Keijinkai Hospital, Sapporo, Japan; Department of Gastroenterological Surgery II, Hokkaido University Graduate School of Medicine, Sapporo, Japan.
出版信息
Int J Surg Case Rep. 2018;49:115-117. doi: 10.1016/j.ijscr.2018.06.032. Epub 2018 Jun 28.
INTRODUCTION
Perineal hernia after abdominoperineal resection (APR) is a rare complication, and no standard surgical procedures are established. We describe a simple laparoscopic mesh implantation technique utilizing a large synthetic flat mesh.
PRESENTATION OF CASE
We report a case of perineal hernia after APR. We performed laparoscopic repair using a soft and large synthetic mesh with simple technique. The essence of this technique is that mesh is inserted into the abdominal cavity without trimming and it forms in a conical shape to better adjust to the pelvic cavity.
DISCUSSION
The perineal and laparoscopic approaches for perineal hernia repair have been performed most commonly in recent years, but the recurrence rate after repair remains high (24.1%). Using a large mesh could cover the hernial orifice with a sufficient margin, reducing a risk of recurrence caused by shrinkage and slippage of the mesh.
CONCLUSION
Our technique utilizing a large, lightweight, synthetic mesh can be practical and useful for perineal hernia repair after laparoscopic APR.
引言
腹会阴联合切除术（APR）后会阴疝是一种罕见的并发症，目前尚无标准的手术方法。我们描述一种利用大型合成扁平补片的简单腹腔镜补片植入技术。
病例介绍
我们报告一例APR后会阴疝病例。我们采用简单技术，使用柔软的大型合成补片进行腹腔镜修补。该技术的关键在于补片无需裁剪即可插入腹腔，并形成圆锥形以更好地适应盆腔。
讨论
近年来，会阴疝修补最常采用会阴和腹腔镜入路，但修补后的复发率仍然很高（24.1%）。使用大型补片可以充分覆盖疝孔边缘，降低因补片收缩和移位导致复发的风险。
结论
我们利用大型、轻质合成补片的技术对于腹腔镜APR后的会阴疝修补可能实用且有效。
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