Arca M J, Heniford B T, Pokorny R, Wilson M A, Mayes J, Gagner M
Division of Laparoscopic Surgery, Mount Sinai Hospital, New York, NY 10029, USA.
J Am Coll Surg. 1998 Aug;187(2):147-52. doi: 10.1016/s1072-7515(98)00124-0.
Lumbar hernias are rare defects in the posterolateral abdominal wall that may be congenital or acquired. Repairing these defects is difficult by virtue of their location and the inherent weakness of the surrounding tissues. We report a series of seven patients who had their lumbar hernias repaired laparoscopically at two institutions.
We retrospectively reviewed all lumbar hernias repaired laparoscopically in our institutions within the last 16 months (August 1996 to November 1997). Postoperative followup was 1-15 months.
Seven patients underwent laparoscopic repair. Five hernias were acquired defects and two were congenital. One to three defects were found per patient. The average size of the hernia defect was 77.8 cm2. We used a polypropylene or a polytetrafluoroethylene mesh in all patients; the average size of the mesh used was 336.4 cm2. The average length of hospital stay was 1.7 days. One patient returned with an abscess over the mesh, which necessitated removal of the graft. Otherwise, there were no complications, and the remaining six patients had no recurrences after followup of 1-14 months.
The laparoscopic approach is safe and effective for repairing lumbar hernias. Advantages of this approach include excellent operative visualization, decreased hospital stay postoperatively, and a solid repair without recurrence during shortterm followup.
腰椎疝是后外侧腹壁的罕见缺损，可能是先天性或后天性的。由于其位置及周围组织固有的薄弱性，修复这些缺损很困难。我们报告了在两家机构接受腹腔镜修复腰椎疝的7例患者。
我们回顾性分析了过去16个月（1996年8月至1997年11月）在我们机构接受腹腔镜修复的所有腰椎疝患者。术后随访1至15个月。
7例患者接受了腹腔镜修复。5例为后天性缺损，2例为先天性缺损。每位患者发现1至3个缺损。疝缺损的平均大小为77.8平方厘米。所有患者均使用聚丙烯或聚四氟乙烯补片；所用补片的平均大小为336.4平方厘米。平均住院时间为1.7天。1例患者补片上方出现脓肿，需要移除移植物。除此之外，无其他并发症，其余6例患者在1至14个月的随访后无复发。
腹腔镜手术方法修复腰椎疝安全有效。该方法的优点包括手术视野极佳、术后住院时间缩短以及在短期随访期间修复牢固无复发。
