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无症状套管针穿刺部位疝:腹腔镜手术被低估的一种并发症。

Asymptomatic trocar site hernias: An underestimated complication of laparoscopy.

作者信息

Üstünyurt Emin, Taşgöz Fatma Nurgül, Tiğrak Sefa

机构信息

University of Health Sciences Turkey, Bursa Yüksek İhtisas Training and Research Hospital, Clinic of Gynecology, Bursa, Turkey.

University of Health Sciences Turkey, Bursa Yüksek İhtisas Training and Research Hospital, Clinic of Radiology, Bursa, Turkey.

出版信息

Turk J Obstet Gynecol. 2020 Sep;17(3):202-208. doi: 10.4274/tjod.galenos.2020.70952. Epub 2020 Oct 2.

DOI:10.4274/tjod.galenos.2020.70952
PMID:33072425
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7538828/
Abstract

OBJECTIVE

To estimate the exact incidence of trocar site hernia (TSH) through sonographic examination and to evaluate the predisposing risk factors of TSH.

MATERIALS AND METHODS

Three hundred patients who underwent laparoscopic surgery for benign gynecologic indications were included in this study and called back for a follow-up visit. All patients underwent an ultrasound evaluation for the detection of TSH. Risk factors for TSH formation were investigated.

RESULTS

Twenty-five (8.3%) TSHs were diagnosed among 300 postoperative laparoscopies. The highest rate of TSH development among the surgeries was found in tubal ligation cases with 19%. Parity ≥3 [odds ratio (OR), 3.13; 95% confidence interval (CI): 1.21-8.09; p=0.018], and not closing fascia (OR: 6.74; 95% CI: 2.72-16.70; p<0.001) were statistically significant risk factors for the development of TSH in multivariate analysis.

CONCLUSION

The prevalence of TSH is higher than previously reported, and ultrasonographic examination is adequate for detecting subclinical types of this complication.

摘要

目的

通过超声检查评估套管针穿刺部位疝(TSH)的准确发病率,并评估TSH的易感风险因素。

材料与方法

本研究纳入300例因良性妇科疾病接受腹腔镜手术的患者,并召回进行随访。所有患者均接受超声检查以检测TSH。对TSH形成的风险因素进行调查。

结果

300例术后腹腔镜检查中诊断出25例(8.3%)TSH。输卵管结扎手术中TSH发生率最高,为19%。多因素分析显示,产次≥3(比值比[OR],3.13;95%置信区间[CI]:1.21-8.09;p=0.018)和未关闭筋膜(OR:6.74;95%CI:2.72-16.70;p<0.001)是TSH发生的统计学显著风险因素。

结论

TSH的患病率高于先前报道,超声检查足以检测该并发症的亚临床类型。

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本文引用的文献

1
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Chin Med J (Engl). 2019 Nov 20;132(22):2677-2683. doi: 10.1097/CM9.0000000000000510.
2
Trocar Site Hernias in Bariatric Surgery-an Underestimated Issue: a Qualitative Systematic Review and Meta-Analysis.减重手术中的套管部位疝:一个被低估的问题:定性系统评价和荟萃分析。
Obes Surg. 2019 Mar;29(3):1049-1057. doi: 10.1007/s11695-018-03687-2.
3
Trocar Site Hernia After Gastric Bypass.胃旁路术后套管针穿刺部位疝
Thoughts on Trocar Site Hernia Prevention. A Narrative Review.
关于预防套管针穿刺部位疝的思考。一篇叙述性综述。
J Abdom Wall Surg. 2022 Dec 21;1:11034. doi: 10.3389/jaws.2022.11034. eCollection 2022.
4
Trocar site hernia after gastric sleeve.胃袖套术后套管部位疝。
Surg Endosc. 2022 Jun;36(6):4386-4391. doi: 10.1007/s00464-021-08787-2. Epub 2021 Oct 26.
Surg Technol Int. 2017 Jul 25;30:170-174.
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Port-site incisional hernia - A case series of 54 patients.切口疝——54例病例系列
Ann Med Surg (Lond). 2017 Jan 6;14:8-11. doi: 10.1016/j.amsu.2017.01.001. eCollection 2017 Feb.
5
5-millimeter Trocar-site Hernias After Laparoscopy Requiring Surgical Repair.腹腔镜检查后需手术修复的5毫米套管针穿刺部位疝
J Minim Invasive Gynecol. 2016 May-Jun;23(4):505-11. doi: 10.1016/j.jmig.2016.03.001. Epub 2016 Mar 10.
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J Endourol. 2016 Jan;30(1):92-6. doi: 10.1089/end.2015.0431. Epub 2015 Oct 20.
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