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腹腔镜腹疝修补术的前瞻性多中心研究。初步结果。

Prospective, multicenter study of laparoscopic ventral hernioplasty. Preliminary results.

作者信息

Toy F K, Bailey R W, Carey S, Chappuis C W, Gagner M, Josephs L G, Mangiante E C, Park A E, Pomp A, Smoot R T, Uddo J F, Voeller G R

机构信息

Community Medical Center, 1800 Mulberry Street, Scranton, PA 18510, USA.

出版信息

Surg Endosc. 1998 Jul;12(7):955-9. doi: 10.1007/s004649900755.

Abstract

BACKGROUND

A standard technique for laparoscopic ventral hernioplasty (peritoneal onlay using an expanded polytetrafluoroethylene [ePTFE] patch for hernias >/=4 cm2) is being used in a prospective, multicenter, long-term study.

METHODS

Demographic, operative, and postoperative data were collected and analyzed. Follow-up clinical evaluations were conducted 7-10 days, 4 weeks, 6 months, 1 year, and then annually after surgery in all patients.

RESULTS

In the first 2 years of the study, 144 patients were enrolled; nine were lost to follow-up. The mean operating time was 120 min. The mean follow-up was 222 days (range 5-731). Postoperative complications were five infections, three cases of prolonged ileus, one bowel obstruction, 23 seromas (15 resolved without intervention), and six hernia recurrences. Hospital discharge occurred a mean of 2.3 days after surgery and return to normal activity a mean of 15 days postoperatively.

CONCLUSIONS

Laparoscopic prosthetic ventral hernioplasty avoids the large wound required in open repairs, with attendant complications and recurrences, and appears safe, especially if an ePTFE mesh is used. Compared with conventional open ventral hernioplasty, the laparoscopic technique may also allow shorter hospitalization and a quicker return to normal activities after surgery.

摘要

背景

一种用于腹腔镜腹疝修补术的标准技术(对于疝面积≥4平方厘米的患者,采用腹膜外置入膨化聚四氟乙烯[ePTFE]补片)正在一项前瞻性、多中心、长期研究中使用。

方法

收集并分析人口统计学、手术及术后数据。所有患者在术后7 - 10天、4周、6个月、1年进行随访临床评估,之后每年进行一次。

结果

在研究的前两年,共纳入144例患者;9例失访。平均手术时间为120分钟。平均随访时间为222天(范围5 - 731天)。术后并发症包括5例感染、3例肠梗阻延长、1例肠梗阻、23例血清肿(15例未经干预自行消退)和6例疝复发。平均术后2.3天出院,术后平均15天恢复正常活动。

结论

腹腔镜人工材料腹疝修补术避免了开放修补所需的大伤口以及随之而来的并发症和复发,似乎是安全的,尤其是使用ePTFE补片时。与传统开放腹疝修补术相比,腹腔镜技术还可能使住院时间缩短,术后更快恢复正常活动。

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