腹壁切口疝的外科治疗体会(附160例临床分析)

Investigation on Surgical Treatment of Abdominal Incisional Hernia(Analysis for 160 Cases)

目的总结腹壁切口疝的病因、病程、手术治疗的方式与效果。方法回顾性分析160例腹壁切口疝的原发疾病、病程、分类、手术方式和随访情况。结果平均随访时间为48个月,160例中小、中、大和巨大切口疝分别为42、60、36、22例,行单纯缝合修补22例,复发4例(18.2%);行人工合成材料修补138例,复发9例(6.5%)。其中开腹手术125例,复发11例(8.8%),腹腔镜手术35例,复发2例(5.7%)。结论手术方式的选择应根据切口疝患者的具体情况作个体化的方案,人工合成材料修补和腹腔镜手术是效果较好的治疗手段。

Objective To review the causes, procedure, clinical operation methods of abdominal incisional hernia. Methods Primary disease, procedure ,classification, operation method and fellow-up of 160 patients with abdominal incisional hernia were retrospectively analyzed. Results The average time of fellow-up was 48 months. 42 cases were small abdominal incisional hernia,60 cases were middle, 36 cases were big and 22 cases were huge abdominal incisional hernia in 160 cases. 22 cases were repaired with simple suture with 4 cases recurrence （ 18.2% ） , 138 cases were repaired with man-made material with 9 cases recurrence（6.5% ）. 125 cases were treated by open operation with 11 cases recurrence（8.8% ）, and 35 cases were treated by laparoscopic operation with 2 cases recurrence（5.7% ）. Conclusions Individual operation method should be chosen according to body condition, classification of the size of abdominal loss and abdominal hypertension. It is an effective method to repair the hernia of abdominal incision with man-made material and laparoscopic operation.