• 解放軍總醫(yī)院第一附屬醫(yī)院普通外科(北京 100048);

目的 初步探討并總結(jié)腹腔鏡下腹腔內(nèi)置補(bǔ)片法修補(bǔ)70歲以上老年患者腹壁切口疝的臨床經(jīng)驗(yàn)。
方法 回顧性分析了我院2005年7月至2008年7月期間實(shí)施的8例腹腔鏡下腹腔內(nèi)置補(bǔ)片法修補(bǔ)70歲以上老年患者腹壁切口疝的臨床資料。
結(jié)果 8例中有1例因腹腔粘連嚴(yán)重而中轉(zhuǎn)開腹手術(shù),其余7例均成功完成腹腔鏡下疝修補(bǔ)手術(shù); 手術(shù)時(shí)間50～180 min,平均105 min; 術(shù)后1例發(fā)生高碳酸血癥導(dǎo)致昏迷,經(jīng)呼吸機(jī)輔助呼吸24 h后好轉(zhuǎn); 1例發(fā)生血清腫,1例術(shù)區(qū)明顯疼痛超過1個(gè)月,均經(jīng)保守治療治愈; 住院時(shí)間7～14 d,平均9.5 d。術(shù)后隨訪12～36個(gè)月(平均26.5個(gè)月)無復(fù)發(fā),無局部不適。
結(jié)論 腹腔鏡下腹腔內(nèi)置補(bǔ)片法修補(bǔ)70歲以上患者的腹壁切口疝是安全、可行的,且具有微創(chuàng)、恢復(fù)快等優(yōu)點(diǎn),但必須注意圍手術(shù)期處理及手術(shù)技巧。

引用本文： 費(fèi)陽,李基業(yè). 腹腔鏡下修補(bǔ)70歲以上患者腹壁切口疝(附8例報(bào)道). 中國普外基礎(chǔ)與臨床雜志, 2010, 17(3): 263-266. doi: 復(fù)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.
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(yī)學(xué)會(huì)外科學(xué)分會(huì)疝和腹壁外科學(xué)組. 腹股溝疝、股疝和腹壁切口疝手術(shù)治療方案草案 [J]. 中國實(shí)用外科雜志, 2001; 21(10): 篇首.
7. 李基業(yè). 巨大切口疝的現(xiàn)代外科治療 [J]. 中國普外基礎(chǔ)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(xiàn)狀與進(jìn)展 [J]. 中國普外基礎(chǔ)與臨床雜志, 2003; 10(1): 13.
12. 李基業(yè), 馬頌章. 腹部手術(shù)切口疝手術(shù)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(bǔ)手術(shù)222例經(jīng)驗(yàn) [J]. 中國普外基礎(chǔ)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. 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. 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. 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. 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. 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. 6. 中華醫(yī)學(xué)會(huì)外科學(xué)分會(huì)疝和腹壁外科學(xué)組. 腹股溝疝、股疝和腹壁切口疝手術(shù)治療方案草案 [J]. 中國實(shí)用外科雜志, 2001; 21(10): 篇首.
  7. 7. 李基業(yè). 巨大切口疝的現(xiàn)代外科治療 [J]. 中國普外基礎(chǔ)與臨床雜志, 2003; 10(1): 1012.
  8. 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. 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. 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. 11. 馬頌章. 疝和腹壁外科的現(xiàn)狀與進(jìn)展 [J]. 中國普外基礎(chǔ)與臨床雜志, 2003; 10(1): 13.
  12. 12. 李基業(yè), 馬頌章. 腹部手術(shù)切口疝手術(shù)治療方案(草案) [J]. 中華普通外科雜志, 2004; 19(2): 125.
  13. 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. 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. 15. Burch JM, Moore EE, Moore FA, et al. The abdominal compartment syndrome [J]. Surg Clin North Am, 1996; 76(4): 833842.
  16. 16. 王存川， 張松柏， 陳鎣， 等. 腹腔鏡疝修補(bǔ)手術(shù)222例經(jīng)驗(yàn) [J]. 中國普外基礎(chǔ)與臨床雜志， 2005； 12（6）： 551553.
  17. 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.