杂交技术治疗巨大切口疝

Hybrid technique in the treatment of huge abdominal incisional hernia: An analysis of clinic therapeutic effect

目的评估运用切除疝囊、组织分离、结合腹腔镜的杂交技术治疗巨大腹壁切口疝可行性及临床价值。方法回顾性分析2008年1月至2013年5月,首都医科大学附属北京朝阳医院西区采用单纯开放手术及杂交技术治疗的巨大腹壁切口疝195例患者的临床资料（主动减容患者除外）。对比二种手术方法手术难度、安全性、并发症、术后恢复及术后复发等情况。结果二种手术方法的时间接近。杂交组切口长度（8±4）cm明显小于开放组（15±5）cm。开放组和杂交组住院时间相当。术后随访6～48个月。二组并发症比较,开放组的浆液肿10例高于杂交组4例,均无术后死亡。开放组术后复发1例,杂交组无复发;复发患者均于术后2年内再次接受杂交技术治疗并治愈。结论应用杂交技术治疗巨大腹壁切口疝较开放手术具有一定的优势。

Objective To analyze the clinical value of the hybrid technique in the treatment of huge abdominal incisional hernia. Methods The clinical data of 195 cases of huge abdominal incisional hernia admitted to Beijing Chao-yang Hospital from January 2008 to May 2013 were analyzed retrospectively. The operational course and the postoperative status among open（ 93 cases） and the hybrid technique（ 102 cases） performed in huge abdominal incisional hernia were compared. Results The mean time of operation in the open group and the hybrid technique are similar. The length of incision in the hybrid group（ 8 ± 4） cm was shorter than that in the open group（ 15 ± 5） cm. The follow-up ranged from 6 to 48 months.10 cases developed complication in the open group,4 in the hybrid group,and no death cases. One case developed recurrence in the open group,none in the hybrid group. All the recurrent cases were cured by hybrid technique in 2 years after operation. Conclusion The hybrid technique has superior advantages compared with open technique in the treatment of huge abdominal incisional hernia.