腹腔镜腹壁切口疝修补术15例临床分析

Laparoscopic incisional hernia repair：a clinical analysis of 15 cases

目的：探讨腹腔镜腹壁切口疝修补术的治疗经验和体会。方法回顾性分析15例腹腔镜切口疝修补术患者临床资料。结果15例均在腔镜下完成切口疝修补术，手术时间60～180 min，平均（117．00±30．46）min，术后排气时间1～2 d，平均住院时间（16．53±3．46）d。术中无肠管浆膜层损伤、大出血病例。无术后血肿、切口感染、补片感染、肠瘘或死亡病例。10例患者（66．67％）有不同程度的腹壁钉合区域疼痛。术后随访2～11个月，无复发病例。结论腹腔镜下采用钉合器或钉合器加缝线贯穿腹壁双重固定补片法修补腹壁切口疝安全、有效。腹腔镜切口疝修补术具有创伤小、恢复快、并发症发生率及复发率低等优点。

Objective To explore the experience of diagnosis and treatment of laparoscopic abdominal inci-sion hernia repair.Methods The clinical data of 15 patients treated with laparoscopic incision hernia repair were ret-rospectively analyzed.Results All 15 cases were successful in operation by laparoscopy.The operation time was 60~180 mins,and the mean operation time was （117 ±30.46） mins,the post-operation aerofluxus time was 1~2 days and the mean time of post-operation hospital stay was （16.53 ±3.46） days.During the operation no association with serosal layer damage or massive hemorrhage occurred;no postoperative seroma infection,intestinal fistula,infec-tion of incision,patches or deaths occurred.Ten patients（66.67%） had abdominal wall nail regional pain to different degree.2~11 months′postoperative follow-up indicated no recurrent cases.Conclusion Laparoscopic adoption of stapler or stapler with sutures through abdominal wall to repair incisional hernia is safe and effective.Compared with the open surgery,laparoscopic incisional hernia repair has the advantage of minor injury,quicker recovery,and lower recurrence rate.