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脐疝和脐旁疝修补术中同期手术操作:可行还是必需?

SIMULTANEOUS OPERATIONS DURING UMBILICAL AND PARAUMBILICAL HERNIA REPAIR: POSSIBLE OR NECESSARY?

机构信息

STATE INSTITUTION «INSTITUTE OF GENERAL AND EMERGENCY SURGERY NAMED AFTER V.T. ZAITSEV OF THE NATIONAL ACADEMY OF MEDICAL SCIENCES OF UKRAINE», KHARKIV, UKRAINE.

KHARKIV NATIONAL MEDICAL UNIVERSITY, KHARKIV, UKRAINE.

出版信息

Wiad Lek. 2021;74(2):220-224.

Abstract

OBJECTIVE

The aim of the study was to determine the possibility and effectiveness of simultaneous surgical interventions in umbilical and paraumbilical hernia repair.

PATIENTS AND METHODS

Material and methods: 148 case histories were analyzed concerning patients who were routinely admitted to the surgical department of the Kharkiv Regional Council's Municipal Non-Profit Enterprise «Regional Clinical Hospital» between 2017 and 2019, and who underwent umbilical and paraumbilical hernia repair simultaneously with operations related to some other surgical pathology (group 1, n = 67) or in separate interventions (group 2, n = 81). All patients were routinely operated after a set of mandatory and additional general clinical, laboratory and instrumental research conducted in accordance with the existing guidelines. The structure and results of surgical interventions related to the underlying disease and simultaneous operations were studied.

RESULTS

Results: Simultaneous operations were performed for comorbid cholecystolithiasis, diaphragmatic esophageal hernia with gastroesophageal reflux, inguinal hernia, white line hernia, benign diseases of the uterus and uterine appendages et al. The frequency of complications and recurrences of hernia in patients with simultaneous and isolated of umbilical hernia repair did not differ significantly. The outcome of the operation mostly depended on the method of operation (postoperative complications were most often observed in open sutures repair and were absent in laparoscopic hernia repair). Additional risk factors were weight gain and diabetes.

CONCLUSION

Conclusions: Summarizing the data obtained, it can be concluded that application of modern endovideoscopic techniques in surgery makes simultaneous surgical interventions not only possible but also necessary in the presence of concomitant abdominal pathology that requires surgical treatment.

摘要

目的

本研究旨在确定同时进行脐疝和脐旁疝修补术的可能性和有效性。

患者和方法

对 2017 年至 2019 年期间常规入住哈尔科夫地区委员会市非营利企业“地区临床医院”外科部门并同时接受脐疝和脐旁疝修补术的患者的 148 例病史进行分析,这些患者与其他一些外科病理相关的手术(第 1 组,n = 67)或单独手术(第 2 组,n = 81)。所有患者均按照现行指南常规进行一系列强制性和额外的一般临床、实验室和仪器研究后进行手术。研究了与基础疾病和同时手术相关的手术干预的结构和结果。

结果

结果:同时进行了胆囊结石症、膈食管裂孔疝伴胃食管反流、腹股沟疝、白线疝、子宫和附件良性疾病等合并症的手术。同时行脐疝修复术和单独行脐疝修复术患者的并发症和疝复发率无显著差异。手术结果主要取决于手术方法(开放性缝合修复术后并发症最常见,腹腔镜疝修复术后则无并发症)。其他危险因素是体重增加和糖尿病。

结论

结论:总结获得的数据,可以得出结论,在存在需要手术治疗的合并腹部病理的情况下,应用现代内镜技术进行手术不仅可行,而且必要。

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