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后腹腔镜肾上腺切除术后疝,病例报告。

Hernia after retroperitoneoscopic adrenalectomy, case report.

作者信息

Magyar Christian T J, Nebiker Christian A

机构信息

Resident in Surgery, Klinik für Viszeralchirurgie, Kantonsspital Aarau, Aarau, Switzerland.

Consultant Surgeon, Klinik für Viszeralchirurgie, Kantonsspital Aarau, Aarau, Switzerland.

出版信息

Gland Surg. 2020 Apr;9(2):442-446. doi: 10.21037/gs.2020.01.03.

Abstract

We report the first case of a previously undocumented complication after posterior retroperitoneal adrenalectomy (PRA). Extensive diagnostic procedures for persisting abdominal pain led to diagnosis of an incisional hernia (IH) approximately 2.5 years after surgery for a pheochromocytoma of the right adrenal gland. Thus, IHs need to be recognized as a potential complication after PRA, particularly if the symptoms are non-specific. The differential diagnosis of an IH after PRA includes a type of spontaneous lumbar hernia due to a pre-existing weakness of the abdominal wall however the treatment for both type of hernias is similar by mesh repair. A possible risk factor for IH after PRA might be obesity, due to different factors including difficulties in closing the fascia in depth under subcutaneous tissue.

摘要

我们报告了首例后腹腔镜肾上腺切除术(PRA)后出现的一种此前未记录的并发症。针对持续腹痛进行的广泛诊断程序导致在右侧肾上腺嗜铬细胞瘤手术后约2.5年诊断出切口疝(IH)。因此,IH需要被视为PRA后的一种潜在并发症,特别是当症状不具有特异性时。PRA后IH的鉴别诊断包括一种因腹壁预先存在薄弱导致的自发性腰疝,然而这两种疝的治疗方法通过网片修补是相似的。PRA后IH的一个可能危险因素可能是肥胖,这是由于包括在皮下组织深处闭合筋膜困难等不同因素导致的。

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本文引用的文献

1
Understanding Retroperitoneal Anatomy for Lateral Approach Spine Surgery.了解用于脊柱外侧入路手术的腹膜后解剖结构。
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Hand-Assisted Nephrectomy Predisposes Incisional Herniation in Obese Living Donors.手辅助肾切除术易导致肥胖活体供者发生切口疝。
Transplant Proc. 2019 Sep;51(7):2210-2214. doi: 10.1016/j.transproceed.2019.02.042. Epub 2019 Aug 1.
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Microscopic anatomy of the visceral fasciae.内脏筋膜的微观解剖学。
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