腹腔鏡下修補70歲以上患者腹壁切口疝(附8例報道)_《中國普外基礎與臨床雜志》

作者：

費陽 , 李基業

解放軍總醫院第一附屬醫院普通外科(北京 100048);

關鍵詞：

腹壁切口疝腹腔鏡腹腔內置補片高齡

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目的初步探討并總結腹腔鏡下腹腔內置補片法修補70歲以上老年患者腹壁切口疝的臨床經驗。
方法回顧性分析了我院2005年7月至2008年7月期間實施的8例腹腔鏡下腹腔內置補片法修補70歲以上老年患者腹壁切口疝的臨床資料。
結果 8例中有1例因腹腔粘連嚴重而中轉開腹手術,其余7例均成功完成腹腔鏡下疝修補手術; 手術時間50～180 min,平均105 min; 術后1例發生高碳酸血癥導致昏迷,經呼吸機輔助呼吸24 h后好轉; 1例發生血清腫,1例術區明顯疼痛超過1個月,均經保守治療治愈; 住院時間7～14 d,平均9.5 d。術后隨訪12～36個月(平均26.5個月)無復發,無局部不適。
結論腹腔鏡下腹腔內置補片法修補70歲以上患者的腹壁切口疝是安全、可行的,且具有微創、恢復快等優點,但必須注意圍手術期處理及手術技巧。

引用本文： 費陽,李基業. 腹腔鏡下修補70歲以上患者腹壁切口疝(附8例報道). 中國普外基礎與臨床雜志, 2010, 17(3): 263-266. doi: 復制

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2.	van’t RM, De Vos Van Steenwijk PJ, Bonjer HJ, et al. Incisional hernia after repair of wound dehiscence: incidence and risk factors [J]. Am Surg, 2004; 70(4): 281286.
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4.	Heniford BT, Park A, Ramshaw BJ, et al. Laparoscopic repair of ventral hernias: nine years’ experience with 850 consecutive hernias [J]. Ann Surg, 2003; 238(3): 391400.
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11.	馬頌章. 疝和腹壁外科的現狀與進展 [J]. 中國普外基礎與臨床雜志, 2003; 10(1): 13.
12.	李基業, 馬頌章. 腹部手術切口疝手術治療方案(草案) [J]. 中華普通外科雜志, 2004; 19(2): 125.
13.	Korenkov M, Paul A, Sauerland S, et al. Classification and surgical treatment of incisional hernia. Results of an experts’ meeting [J]. Langenbecks Arch Surg, 2001; 386(1): 6573.
14.	Nitta AT, Iseman MD, Newell JD, et al. Tenyear experience with artificial pneumoperitoneum for endstage, drugresistant pulmonary tuberculosis [J]. Clin Infect Dis, 1993; 16(2): 219222.
15.	Burch JM, Moore EE, Moore FA, et al. The abdominal compartment syndrome [J]. Surg Clin North Am, 1996; 76(4): 833842.
16.	王存川，張松柏，陳鎣，等. 腹腔鏡疝修補手術222例經驗 [J]. 中國普外基礎與臨床雜志， 2005； 12（6）： 551553.
17.	Aura T, Habib E, Mekkaoui M, et al. Laparoscopic tensionfree repair of anterior abdominal wall incisional and ventral hernias with an intraperitoneal GoreTex mesh: prospective study and review of the literature [J]. J Laparoendosc Adv Surg Tech A, 2002; 12(4): 263267.

1. Mudge M, Hughes LE. Incisional hernia: a 10 year prospective study of incidence and attitudes [J]. Br J Surg, 1985; 72(1): 7071.
2. van’t RM, De Vos Van Steenwijk PJ, Bonjer HJ, et al. Incisional hernia after repair of wound dehiscence: incidence and risk factors [J]. Am Surg, 2004; 70(4): 281286.
3. YahchouchyChouillard E, Aura T, Picone O, et al. Incisional hernias. Ⅰ. Related risk factors [J]. Dig Surg, 2003; 20(1): 39.
4. Heniford BT, Park A, Ramshaw BJ, et al. Laparoscopic repair of ventral hernias: nine years’ experience with 850 consecutive hernias [J]. Ann Surg, 2003; 238(3): 391400.
5. Benhidjeb T, Benecke C, Strik MW. Incisional hernia repair: sublay or intraperitoneal onlay mesh (IPOM)? [J]. Zentralbl Chir, 2008; 133(5): 458463.
6. 中華醫學會外科學分會疝和腹壁外科學組. 腹股溝疝、股疝和腹壁切口疝手術治療方案草案 [J]. 中國實用外科雜志, 2001; 21(10): 篇首.
7. 李基業. 巨大切口疝的現代外科治療 [J]. 中國普外基礎與臨床雜志, 2003; 10(1): 1012.
8. LeBlanc KA, Booth WV. Laparoscopic repair of incisional abdominal hernias using expanded polytetrafluoroethylene: preliminary findings [J]. Surg Laparosc Endosc, 1993; 3(1): 3941.
9. Sains PS, Tilney HS, Purkayastha S, et al. Outcomes following laparoscopic versus open repair of incisional hernia [J]. World J Surg, 2006; 30(11): 20562064.
10. Rudmik LR, Schieman C, Dixon E, et al. Laparoscopic incisional hernia repair: a review of the literature [J]. Hernia, 2006; 10(2): 110119.
11. 馬頌章. 疝和腹壁外科的現狀與進展 [J]. 中國普外基礎與臨床雜志, 2003; 10(1): 13.
12. 李基業, 馬頌章. 腹部手術切口疝手術治療方案(草案) [J]. 中華普通外科雜志, 2004; 19(2): 125.
13. Korenkov M, Paul A, Sauerland S, et al. Classification and surgical treatment of incisional hernia. Results of an experts’ meeting [J]. Langenbecks Arch Surg, 2001; 386(1): 6573.
14. Nitta AT, Iseman MD, Newell JD, et al. Tenyear experience with artificial pneumoperitoneum for endstage, drugresistant pulmonary tuberculosis [J]. Clin Infect Dis, 1993; 16(2): 219222.
15. Burch JM, Moore EE, Moore FA, et al. The abdominal compartment syndrome [J]. Surg Clin North Am, 1996; 76(4): 833842.
16. 王存川，張松柏，陳鎣，等. 腹腔鏡疝修補手術222例經驗 [J]. 中國普外基礎與臨床雜志， 2005； 12（6）： 551553.
17. Aura T, Habib E, Mekkaoui M, et al. Laparoscopic tensionfree repair of anterior abdominal wall incisional and ventral hernias with an intraperitoneal GoreTex mesh: prospective study and review of the literature [J]. J Laparoendosc Adv Surg Tech A, 2002; 12(4): 263267.

《中國普外基礎與臨床雜志》

腹腔鏡下修補70歲以上患者腹壁切口疝(附8例報道)

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《中國普外基礎與臨床雜志》

腹腔鏡下修補70歲以上患者腹壁切口疝(附8例報道)

摘要 全文 圖表 視頻 參考文獻 施引文獻 補充材料

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