无张力修补术在腹壁疝中的应用  

Tension-free ventral and incisional hernia repair

作　　者：李俊生[1] 嵇振岭[1] 袁琮愇[1] 汤文浩[1] 张亚男[1] 鞠兴唐[1] 范新[1] 陈卫东[1] 

机构地区：[1]东南大学临床医学院附属中大医院普外科,南京210009

出　　处：《中华疝和腹壁外科杂志（电子版）》2009年第2期33-35,共3页Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition)

摘　　要：目的探讨腹壁疝的无张力补片修补方法,总结腹壁疝的治疗经验。方法回顾性分析我科2004年10月至2008年11月间收治的25例腹壁疝患者的临床资料。24例手术采用全麻或硬膜外麻醉下的腹膜外补片无张力修补术。1例应用巴德CK补片,置于腹腔内。结果本组患者中,男性9例,女性16例;年龄37～81岁,平均年龄(68±10)岁。其中白线疝1例,半月环疝1例,脐疝6例,切口疝17例。腹壁切口疝疝环直径1～18 cm,平均(7±4)cm。均采用无张力疝修补术,平均手术时间(116±42)min(40～210 min)。平均住院时间(8±3)d(3～16 d)。术后1例发生轻微疼痛不适;术后2例发生浆液肿,经穿刺治愈;1例发生上呼吸道感染;随访6～48个月,无复发。结论采用人工补片行腹壁疝无张力修补术是一种安全可靠的手术方式,采用腹膜外修补方式进行手术,避免了补片与腹腔内脏器的直接接触,并发症少,复发率低。Objective Ventral and incisional hernias are a common surgical problem. In this stud- y, we reported our experience in ventral-incisional hernia repair. Methods 25 patients with ventral and in- cisional hernias were included in this study from Oct 2004 to Nov 2008. Patients were operated either under general or epidural anesthesia. 1 case was repaired with BARD composix mesh with intra-abdominal proce- dure, the rest patients were repaired with BARD Kugel or Modified Kugel Patches, with the patch were placed either in the retro-rcctus place （7 cases） or prepcritoneal place （17 cases）. Results 9 male and 16 female patients with ventral and incisional hernias, aged from 37 to 81 （mean, 68±10 ） , were submitted to tension-free prosthetic mesh implantation. There were 1 epigastric hernia, 1 spigelian hernia, 6 umbilical hernias and 17 incisional hernias with the defect size ranging from 1 to 18 （mean,7 ± 4） cm. Postoperative complications were seroma in 2 cases, upper respiratory infection in 1 case, mild discomfort experienced in 1 patient. The mean operation time was （116±42） rain, mean hospital stay was （8 ±3） d. There was no re- currence during the follow-up time （6 to 48 months）. Conclusions The advantages of this procedure are its simplicity and safety. Most of the patients could be operated with the preperitoneal procedure, avoiding the direct contact of the patch and intestine.

关 键 词：腹壁疝 外科手术 补片 无张力疝修补术 

分 类 号：R656.2[医药卫生—外科学]