腹腔镜下腹腔内补片植入术治疗腹白线疝可行性分析

Feasibility of laparoscopic intraperitoneal onlay mesh surgery of linea alba hernia

目的探讨腹腔镜下治疗腹白线疝可行性及安全性。方法回顾性分析2015年1月至2016年10月,首都医科大学附属北京朝阳医院收治的20例腹白线疝患者,术前均诊断明确,于全麻气管插管下行腹腔镜下腹腔内补片植入术(Intraperitoneal Onlay Mesh,IPOM)。对患者的手术时间、术中出血量、中转开腹情况、补片使用情况、住院时间、术后并发症进行分析。结果 20例腹白线疝患者均在腹腔镜下成功完成手术,无中转开腹病例,平均手术时间(45.5±21.5)min,术中出血量少、平均(5.78±4.07)ml,术中均放置腹腔内专用防粘连补片,住院时间短、平均(8.65±3.31)d,术后均治愈出院,随访4~25个月,无一例发生补片感染、长期慢性疼痛、肠梗阻、疝复发等严重并发症。结论腹腔镜下IPOM术治疗腹白线疝安全、可行,疗效可靠。

Objective To evaluate the feasibility and security of laparoscopic Intraperitoneal Onlay Mesh of linea alba hernia. Methods A retrospective study was performed to analysis the clinical data of 20 cases of linea alba hernia accepted Intraperitoneal Onlay Mesh Surgery in Beijing Chao-Yang Hospital during the period of January 2015 to October 2016. The operation times, intraoperative blood loss, conversion to open operation, the patch used, hospital stays, and postoperative complications were analyzed.Results All the operations were finished successfully with less blooding and no open conversion case, average operating time（45.5±21.5） min, average blood loss（5.78±4.07） ml. They all operated with the special intraperitoneal anti-adhesion patch, cured and discharged from hospital quickly, average hospital stay（8.65±3.31） d. All the patients were followed up for 4 to 25 months, and no case was reported with complication such as patch infection, long-term chronic pain, intestinal obstruction and hernia recurrence. Conclusion Laparoscopic intraperitoneal onlay mesh surgery in linea alba hernia is a safe, feasible and effective method with satisfactory results.