腹腔镜腹壁疝修补术对切口疝患者的临床疗效及胃肠功能的影响

Clinical efficacy of laparoscopic ventral hernia repair in patients with incisional hernia and the effect on gastrointestinal function

目的探讨腹腔镜腹壁疝修补术对切口疝患者的临床疗效及对其胃肠功能的影响。方法选取上海市宝山区吴淞中心医院2016年11月至2019年10月收治的68例腹壁切口疝患者。将所有患者按手术方式分为腹腔镜组(34例)和开放组(34例)。开放组行开放腹壁疝修补手术,腹腔镜组行腹腔镜疝修补术。记录并比较2组患者术中及术后恢复指标、胃肠功能指标及术后并发症发生率。结果腹腔镜组术中出血量明显少于开放组,腹腔镜组切口愈合时间、下床活动时间、住院时间均明显短于开放组,腹腔镜组住院费用明显高于开放组,腹腔镜组胃肠功能指标(首次进食时间、首次肠鸣音时间、首次肛门排气时间、首次排便时间)均明显短于开放组,腹腔镜组的术后并发症发生率明显低于开放组,差异均有统计学意义(均P<0.05)。结论腹腔镜腹壁疝修补术治疗切口疝患者临床疗效显著,与开放手术相比,术中出血量小,术后恢复快,术后并发症发生率低,且能有效促进患者胃肠功能恢复,但治疗费用相对较高。

Objective To investigate the clinical efficacy of laparoscopic ventral hernia repair(LVHR)on patients with incisional hernia and its effect on their gastrointestinal function.Methods Sixty-eight patients with incisional hernia of the abdominal wall admitted to our general surgery department from November 2016 to October 2019 were selected.All patients were divided into a laparoscopic group(34 cases)and an open group(34 cases)according to the surgical method.The open group underwent open repair procedure,and the laparoscopic group underwent laparoscopic hernia repair.Intraoperative data,postoperative recovery data,postoperative gastrointestinal function data and postoperative complication rates were recorded and compared between the 2 groups.Results Intraoperative bleeding was significantly less in the laparoscopic group than in the open group(P<0.05).The incision healing time,time to get out of bed and hospital stay were significantly shorter in the laparoscopic group than in the open group(P<0.05);the hospital cost was significantly higher in the laparoscopic group than in the open group(P<0.05).Gastrointestinal function indexes(first feeding time,first bowel sound time,first anal exhaust time,first defecation time)in laparoscopic group were significantly shorter than those in open group(P<0.05);the incidence of postoperative complications was significantly lower in the laparoscopic group than in the open group(P<0.05).Conclusion Laparoscopic ventral hernia repair is clinically effective in treating patients with incisional hernia,with less intraoperative bleeding,faster postoperative recovery,and lower postoperative complication rate than traditional open surgery,and it can effectively promote the recovery of gastrointestinal function of patients,but the cost of treatment is relatively high.