侧方入路腹腔镜下完全腹膜外成人脐疝修补术5例经验

Laparoscopic total extraperitoneal herniorrhaphy for adult umbilical hernia through a lateral approach:an experience of 5 cases

背景与目的:脐疝是较常见的腹壁疝之一,手术治疗是其唯一可治愈的治疗方法。随着腔镜技术的发展,腔镜在疝与腹壁外科的应用不断深入。本文旨在探讨经侧方入路腹腔镜下完全腹膜外脐疝修补术的可行性及安全性。方法:2019年6月—2020年1月厦门大学附属中山医院普通外科为5例脐疝患者实施侧方入路的腹腔镜下完全腹膜外脐疝修补术,其中男3例,女2例;就诊时年龄30~53岁,平均41.8岁。回顾性分析该5例患者的临床病例资料及随访情况。结果:5例均顺利完成手术;平均手术时间(70.2±5.8)min,术后6~8 h下床活动,术后平均住院时间(3.2±0.7)d;术后脐部积液1例,无出血、肠梗阻、肠瘘等严重并发症;随访1~7个月无复发。结论:经侧方入路行腹腔镜下完全腹膜外成人脐疝修补术安全可行。侧方入路的手术方式操作难度相对较低,临床应用前景良好。

Background and Aims:Umbilical hernia is one of the most common abdominal hernia,and surgical treatment is the only cure for this disease.With the development of endoscopic techniques,the application of endoscopy in hernia and abdominal wall surgery is constantly evolving.This study was conducted to evaluate the feasibility and safety of laparoscopic total extraperitoneal herniorrhaphy using a lateral approach for umbilical hernia in adults.Methods:From June 2019 to January 2020,5 patients with umbilical hernia underwent laparoscopic total extraperitoneal hernia repair via lateral approach in the Department of General Surgery of Zhongshan Hospital affiliated to Xiamen University,including 3 males and 2 females,aged 30–53 years with an average age of41.8 years at the time of consultation.The clinical data and follow-up results of the 5 patients were retrospectively analyzed.Results:Operations were successfully completed in all the 5 patients.The average operative time was (70±5.8) min,the time to postoperative ambulation was 6–8 h,and the average length of postoperative hospital stay was (3.2±0.7) d.After operation,umbilical fluid collections occurred in 1 case,but no serious complications such as bleeding,ileus,intestinal fistula occurred.No recurrence was noted during follow-up period of 1 7 months.Conclusion:Laparoscopic total extraperitoneal herniorrhaphy with lateral approach for adult umbilical hernia is safe and feasible.The operative difficulty of the lateral approach is relatively low and its clinical application may have broad prospects.