Department of Surgery, NYU Langone Hospital - Long Island, Mineola, NY.
College of Medicine, New York Institute of Technology, Old Westbury, NY.
JSLS. 2021 Apr-Jun;25(2). doi: 10.4293/JSLS.2020.00112.
We sought to assess hernia characteristics and classification through comprehensive review of the literature involving broad ligament herniation.
A literature search via MEDLINE and Embase databases was conducted to identify and select broad ligament herniation studies published between January 1, 2000 and September 30, 2020. Extracted data included previous surgical history, previous obstetric history, diagnostic imaging, herniated organ, hernia classification, and repair performed. The reported data has been compared to a unique case of broad ligament herniation that presented to our institution.
A total of 44 articles with 49 cases were identified for the study. Eighteen (36.7%) patients had a history of previous abdominal surgery while 29 (59.2%) had a history of previous childbirth. Type I (51.0%) and Type II (18.4%) defects were most commonly reported with most patients reporting only one defect (85.7%) using the Cilley classification. Twenty-nine patients underwent primary laparoscopic repair of the defect while 19 patients underwent exploratory laparotomy.
The analysis of previously reported cases adds to the limited literature on broad ligament hernias and highlights the surgical management of this uncommon pathology. It also highlights the need for a broad differential diagnosis when female patients present with pelvic pain or symptoms of small bowel obstruction. The broad ligament should be fully inspected when mesenteric defects are suspected as multiple defects can be present as evidenced by the attached case study.
我们通过对广泛韧带疝的文献进行全面回顾，旨在评估疝的特征和分类。
通过 MEDLINE 和 Embase 数据库进行文献检索，以确定并选择 2000 年 1 月 1 日至 2020 年 9 月 30 日期间发表的广泛韧带疝研究。提取的数据包括既往手术史、既往产科史、诊断影像学、疝出器官、疝分类和实施的修复。报告的数据与我们机构收治的一例独特的广泛韧带疝病例进行了比较。
共确定了 44 篇文章，其中涉及 49 例。18 例（36.7%）患者有既往腹部手术史，29 例（59.2%）有既往分娩史。I 型（51.0%）和 II 型（18.4%）缺陷最常见，使用 Cilley 分类法，大多数患者仅报告了一个缺陷（85.7%）。29 例患者行缺陷的初次腹腔镜修复，19 例患者行剖腹探查术。
对以往报道病例的分析增加了对广泛韧带疝有限文献的了解，并强调了这种罕见病理的手术处理方法。它还强调了在女性患者出现盆腔疼痛或小肠梗阻症状时，需要进行广泛的鉴别诊断。当怀疑存在肠系膜缺陷时，应全面检查阔韧带，因为如所附病例研究所示，可能存在多个缺陷。
