腹腔镜切口疝修补术与开放式切口疝修补术的比较研究

Comparision study of therapeutic effection between laparosccopical incision henia repair and open incision henia repair

目的:比较腹腔镜切口疝修补术(LVHR)与开放切口疝修补术(OVHR)的临床疗效。方法:总结我院2005年1月—2011年1月治疗的腹壁切口疝(VIH)72例患者的临床资料,其中OVHR组32例,LVHR组40例。结果 :OVHR组手术时间60～145 min,平均手术时间(90±35)min;术中出血25～200 mL,平均(95±15)mL;住院时间4～35 d,平均(7.5±5.8)d,术区感染3例。LVHR组手术时间35～135 min,平均手术时间(82±32)min;术中出血15～160 mL,平均(85±12)mL,术区感染0例;住院时间3～8 d,平均(5.5±1.6)d。患者随访3个月～5年,OVHR组复发2例(6.3%),LVHR组复发3例(7.5%)。结论:LVHR同OVHR同样安全有效,但LVHR可明显降低切口感染并发症、减少术后疼痛、缩短术后住院时间。

Objective： To compare the safety and benefits of laparoscopic（LVHR） and open incision hernia repai （OVHR）. Methods： The clinical data of 72 patients with incision hernia receiving incision hernia repair in the Fourth Hospital of Harbin Medical University were analyzed among 40 cases which received laparoscopic incision hernia repair and 32 cases received open incision hernia repair. Results： The operative time was 60～ 145 min （mean 90 ± 35 min）and 35～ 135 min（mean82±32 min）in OVHR group and LVHR group respectively. The blood losses were 25 ～ 200 mL（mean 95± 15 mL） and 5 ～ 160 mL（mean 85 ± 12 mL） in OVHR group and LVHR group respectively. Postoperative stay was 4 - 35 d （mean 7.5 ± 5.8 d） and 3 - 8 d （mean 5.5± 1.6 d） （P〈0.05）in OVHR group and LVHR group respectively. Incision infection appeared 3 cases in OVHR group and no in LVHR group （P〈0.05）. Recurrence occurred in 2 cases and 3cases in OVHR group and LVHR group respectively during follow up period of 3 months to 5 years. Conclusion： The laparoscopic incisional hernia repair is a safe and effective method as open incision hernia repair, and laparoscopic incisional hernia repair has less incision infection,can lessen pains and shorten postoperative stay.