腹壁復發切口疝的微創治療體會_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

 張賢坤 ,  劉宏斌 , 韓曉鵬 , 蘇琳 , 李洪濤 , 朱萬坤

蘭州軍區蘭州總醫院普通外科（甘肅蘭州 730050）;

Corresponding?author：

劉宏斌, Email: zhangxk311@sohu.com

Keywords：

腹腔鏡; 切口疝; 疝修補術; 復發

DOI：

10.7507/1007-9424.20150261

Video：

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目的探討腹壁復發切口疝的腹腔鏡治療的臨床效果。方法回顧性分析2010年7月至2014年6月期間我科收治的46例腹壁復發切口疝患者的臨床資料。結果 46例患者均順利完成手術，手術時間65～175 min，（88±10.6）min；術中出血量35～95 mL，（55±6.3）mL；術后住院時間5～17 d，（7.5±2.1）d。術后發生血清腫3例（6.5%），發生腹壁修補區域疼痛2例（4.3%），無切口感染、腸漏等情況發生。術后隨訪（18±4.5）個月（6～26個月）未見復發。結論在恰當選擇病例、根據術中情況決定具體手術方式的情況下，腹腔鏡下行腹壁復發切口疝修補術是安全、可行的，可取得較好的治療效果。

Citation： 張賢坤, 劉宏斌, 韓曉鵬, 蘇琳, 李洪濤, 朱萬坤. 腹壁復發切口疝的微創治療體會. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2015, 22(8): 998-1000. doi: 10.7507/1007-9424.20150261 Copy

1.	Wassenaar EB, Schoenmaeckers EJ, Raymakers JT, et al. Recurre-nces after laparoscopic repair of ventral and incisional hernia:lessons learned from 505 repairs. Surg Endosc, 2009, 23(4):825-832.
2.	馬宏光.切口疝的發生率和復發率的問題.中華疝和腹壁外科雜志:電子版, 2009, 3(4):366-368.
3.	劉飛德, 王世斌, 朱瑛梅, 等.腹壁切口疝補片修補術后復發的再手術治療.中國普外基礎與臨床雜志, 2012, 19(3):300-304.
4.	Moreno-Egea A, Carrillo-Alcaraz A, Aguayo-Albasini JL. Is the outcome of laparoscopic incisional hernia repair affected by defect size? A prospective study. Am J Surg, 2012, 203(1):87-94.
5.	李基業.切口疝合成補片修補后復發疝的再修補.中國普外基礎與臨床雜志, 2013, 20(12):1333-1336.
6.	Davies SW, Turza KC, Sawyer RG, et al. A comparative analysis between laparoscopic and open ventral hernia repair at a tertiary care center. Am Surg, 2012, 78(8):888-892.
7.	Br?ker M, Verdaasdonk E, Karsten T. Components separation technique combined with a double-mesh repair for large midline incisional hernia repair. World J Surg, 2011, 35(11):2399-2402.
8.	Rea R, Falco P, Izzo D, et al. Laparocopic ventral hernia repair with primary transparietal closure of the hernial defect. BMC Surg, 2012, 12 (Suppl 1):S33.
9.	蔣小華.腹腔鏡切口疝修補術的研究進展.中國微創外科雜志, 2013, 13(9):856-858.
10.	Moreno-Egea A, Carrillo-Alcaraz A. Management of non-midline incisional hernia by the laparoscopic approach:results of a long-term follow-up prospective study. Surg Endosc, 2012, 26(4):1069-1078.
11.	Burger JW, Luijendijk RW, Hop WC, et al. Long-term follow-up of a randomized controlled trial of suture versus mesh repair of incisional hernia. Ann Surg, 2004, 240(4):578-585.
12.	Bansal VK, Misra MC, Kumar S, et al. A prospective randomized study comparing suture mesh fixation versus tacker mesh fixation for laparoscopic repair of incisional and ventral hernias. Surg Endosc, 2011, 25(5):1431-1438.
13.	Brill JB, Turner PL. Long-term outcomes with transfascial sutures versus tacks in laparoscopic ventral hernia repair:a review. Am Surg, 2011, 77(4):458-465.
14.	Wassenaar E, Schoenmaeckers E, Raymakers J, et al. Mesh-fixation method and pain and quality of life after laparoscopic ventral or incisional hernia repair:a randomized trial of three fixation techniques. Surg Endosc, 2010, 24(6):1296-1302.
15.	段守信.腹壁切口疝補片修補術后復發的再手術治療分析.現代診斷與治療, 2013, 24(4):914-915.
16.	白明輝, 劉建洛, 張少偉, 等.腹腔鏡下腹壁復發切口疝修補術的臨床體會.實用醫學雜志, 2013, 29(8):1370.

1. Wassenaar EB, Schoenmaeckers EJ, Raymakers JT, et al. Recurre-nces after laparoscopic repair of ventral and incisional hernia:lessons learned from 505 repairs. Surg Endosc, 2009, 23(4):825-832.
2. 馬宏光.切口疝的發生率和復發率的問題.中華疝和腹壁外科雜志:電子版, 2009, 3(4):366-368.
3. 劉飛德, 王世斌, 朱瑛梅, 等.腹壁切口疝補片修補術后復發的再手術治療.中國普外基礎與臨床雜志, 2012, 19(3):300-304.
4. Moreno-Egea A, Carrillo-Alcaraz A, Aguayo-Albasini JL. Is the outcome of laparoscopic incisional hernia repair affected by defect size? A prospective study. Am J Surg, 2012, 203(1):87-94.
5. 李基業.切口疝合成補片修補后復發疝的再修補.中國普外基礎與臨床雜志, 2013, 20(12):1333-1336.
6. Davies SW, Turza KC, Sawyer RG, et al. A comparative analysis between laparoscopic and open ventral hernia repair at a tertiary care center. Am Surg, 2012, 78(8):888-892.
7. Br?ker M, Verdaasdonk E, Karsten T. Components separation technique combined with a double-mesh repair for large midline incisional hernia repair. World J Surg, 2011, 35(11):2399-2402.
8. Rea R, Falco P, Izzo D, et al. Laparocopic ventral hernia repair with primary transparietal closure of the hernial defect. BMC Surg, 2012, 12 (Suppl 1):S33.
9. 蔣小華.腹腔鏡切口疝修補術的研究進展.中國微創外科雜志, 2013, 13(9):856-858.
10. Moreno-Egea A, Carrillo-Alcaraz A. Management of non-midline incisional hernia by the laparoscopic approach:results of a long-term follow-up prospective study. Surg Endosc, 2012, 26(4):1069-1078.
11. Burger JW, Luijendijk RW, Hop WC, et al. Long-term follow-up of a randomized controlled trial of suture versus mesh repair of incisional hernia. Ann Surg, 2004, 240(4):578-585.
12. Bansal VK, Misra MC, Kumar S, et al. A prospective randomized study comparing suture mesh fixation versus tacker mesh fixation for laparoscopic repair of incisional and ventral hernias. Surg Endosc, 2011, 25(5):1431-1438.
13. Brill JB, Turner PL. Long-term outcomes with transfascial sutures versus tacks in laparoscopic ventral hernia repair:a review. Am Surg, 2011, 77(4):458-465.
14. Wassenaar E, Schoenmaeckers E, Raymakers J, et al. Mesh-fixation method and pain and quality of life after laparoscopic ventral or incisional hernia repair:a randomized trial of three fixation techniques. Surg Endosc, 2010, 24(6):1296-1302.
15. 段守信.腹壁切口疝補片修補術后復發的再手術治療分析.現代診斷與治療, 2013, 24(4):914-915.
16. 白明輝, 劉建洛, 張少偉, 等.腹腔鏡下腹壁復發切口疝修補術的臨床體會.實用醫學雜志, 2013, 29(8):1370.

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腹壁復發切口疝的微創治療體會

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