临床普外科电子杂志 ›› 2023, Vol. 11 ›› Issue (1): 2-.

• •    下一篇

腹腔镜无张力修补术在腹壁切口疝中的临床应用研究

  

  1. 同济大学附属东方医院胶州医院 普外科,山东 胶州 266300
  • 出版日期:2023-01-01 发布日期:2023-03-06

The clinical application effect on the laparoscopic tension-free hernia repair for the treatment of the patients with abdominal incisional hernia

  1. General Surgery Department of Affiliated Jiaozhou Hospital of Tongji University, Shandong Jiaozhou 266300, China
  • Online:2023-01-01 Published:2023-03-06

摘要:

目的 探讨腹腔镜下无张力疝修补术在治疗腹壁切口疝中的临床疗效及预后。方法 回顾性分析同济大学附属东方医院胶州医院2018 年6 月至2021 年6 月收治的72 例腹壁切口疝患者的临床资料。根据术式不同分为试验组和对照组,对照组为开放无张力疝修补手术30 例,试验组为腹腔镜无张力修补术42 例,比较两组的手术时间、术中出血量、住院时间及术后24h 疼痛评分、并发症发生率、切口疝复发情况。结果 试验组患者的手术时间、术中出血量、住院时间及术后24h 疼痛评分明显优于对照组(P <0.05),术后并发症发生率为9.52%(4/42),明显低于对照组30.00%(9/30)(P < 0.05)。术后1 年,试验组复发2 例,复发率为4.76%(2/42),对照组复发3 例,复发率为10.00%(3/30),无明显差异(P > 0.05)。结论 腹腔镜下腹壁切口疝无张力修补术相比于传统开腹修补术,手术时间明显缩短,出血量减少,术后并发症发生率低。腹腔镜下无张力修补术是一种安全、有效的腹壁切口疝微创治疗技术,具有良好的近期和远期临床疗效。

关键词: 腹腔镜, 无张力修补术, 腹壁切口疝

Abstract:

Objective To investigate the clinical effect and prognosis of laparoscopic tension-free hernia repair for the treatment of the patients with abdominal incisional hernia. Method The clinical data of 72 patients with abdominal incisional hernia were retrospectively analyzed in Affiliated Jiaozhou Hospital of Tongji University from June 2018 to June 2021. These patients with abdominal incisional hernia were randomly divided into the experimental group and the control group according to different operation methods including laparoscopic tensionfree repair and open hernia repair. Thirty patients underwent open hernia repair operation in the control group and 42 did laparoscopic tension-free repair in the experimental group. The operation time, intraoperative blood loss,

length of hospital stay and pain score at 24 hours after operation, incidence of complications and recurrent incisional hernia after operation were observed to evaluate the surgical outcome. Result The operation time, intraoperative blood loss, length of hospital stay and pain score at 24 hours after operation in the experimental group were better than those of in the control group (P < 0.05). The postoperative complication rate (9.52%) in the experimental group was significantly lower than that in the control group (30.00%) (P < 0.05).2 patients had recurrence of incisional hernia in the experimental group after 1 year with a recurrence rate was 4.76% (2/42) and 3 patients did recurrence of incisional hernia in the control group after 1 year with a recurrence rate was 10.00% (3/30). There was no obviously significant difference in the recurrence rate of incisional hernia between the experimental group and the control group (P > 0.05). Conclusion Compared with traditional open surgery, laparoscopic tension-free repair for the treatment of the patients with abdominal incisional hernia has many advantages of shorter operation time, less intraoperative blood loss, lower incidence of postoperative complications and lower recurrence rate of abdominal incisional hernia. Laparoscopic tension-free repair for the treatment of the patients with abdominal incisional hernia is a safe and effective minimally invasive technique and has good recent and long-term clinical efficacy at the same time.

Key words: Laparoscopic tension-free repair, Open hernia repair, Incisional hernia of abdominal wall