运用腹腔镜修补腹壁切口疝的术式选择.pdfVIP

全科医学临床与教育 2008年1月 第6卷第1期 Clinical Education of General Practice Jan．2008．Vo1．6．No．1 · 25· 临床研究· 运用腹腔镜修补腹壁切口疝的术式选择 章鲁艇 牟一平 徐晓武 陈其龙 【摘 要] 目的 探讨腹腔镜腹壁切口疝修补术的可行性、安全性及优点。方法 对 18例腹壁切口疝患者施 行两种方式腹腔镜切口疝修补术(完全悬吊法 12例及部分悬吊法6例)，对其临床资料进行回顾性分析。结 果 所有18例腹腔镜腹壁切口疝修补术均顺利完成，无中转开腹。手术时间：完全悬吊法100—180min，部分 悬吊法80—120min；出血 10—30ml；术后6h进食．并下床活动，术后4—6d出院。患者随访 3—57个月，平均 f28．26~10．45)月，未见复发。结论 腹腔镜切口疝修补术符合疝修补的生物力学原理，应是切口疝修补的理 想术式。完全悬吊法虽固定确切，但手术费时；部分悬吊法补片固定牢固，操作简便，易于推广。 『关键词]腹腔镜；切口疝 Selection of laparoscopic methods in treatment of abdominal incisional hefina ZHANG Luting，MOU Yiping，XU Xiaowu，CHEN Qilong．Department of General Surgery，Sir Run Run Show Hospital，Zhejiang University School of Medicine，Hangzhou 3 10016，China ． 【Abstract】 Objective To investigate the feasibility，safety and advantages of laparoscopic approaches to treat abdominal incisional hernia．Methods Undertook a retrospective analysis of 1 8 cases who underwent laparoscopic incisional hernia repair including simple transabdominal sutures procedure for 1 2 cases and transabdominal sutures combine with staples procedure for 6 cases．Results All of the 1 8 laparoscopic incisional hernia repairs were done successfully，none was converted to open surgery．The operation time were 100-180 min for total transabdominal sutures procedure and 80-120 min for transabdominal sutures combine with staples procedure respectively；the blood loss was 10-30 ml；the time of start of liquid diet was 6 h while the patients began to walk at the same time；length of hospital stay was 4-6 d．No recurrence was observed during the 3-57 months follow- up period．Conclusions Laparoscopic incisional hernia repair is technically feasible and safe，with the low complication rate and recurrence rate．It can be considered as the standard of care of abdomina