腹腔镜与开放式手术治疗腹壁切口疝的临床效果比较  

Effects of peritoneoscope and open surgery in treatment of abdominal wall incisional hernia

作　　者：朱俊[1] 商艳霞[1] 冯梅[1] 苏淳月 郭建梅[1] 

机构地区：[1]成都军区昆明总医院、昆明医科大学昆明总医院临床学院普通外科,昆明650032

出　　处：《西南国防医药》2017年第11期1178-1180,共3页Medical Journal of National Defending Forces in Southwest China

摘　　要：目的探讨腹腔镜与开放式手术治疗腹壁切口疝的临床疗效。方法回顾性分析笔者科室2007年1月~2016年9月间收治的63例腹壁切口疝患者的临床资料,根据手术方式将其分为腹腔镜组和开放组,其中腹腔镜组32例,开放组31例,比较两组的手术时间、术后住院天数、术中出血量、术后并发症及复发率等资料。结果两组的术中出血量无显著差异(P>0.05),腹腔镜组的术后住院时间及术后并发症发生率低于开放组(P<0.05)。腹腔镜组1例因疝囊与小肠粘连紧密,分离粘连过程中出现肠瘘,中转改为开腹手术。两组均无患者死亡。术后随访2~80个月,腹腔镜组无复发,开放组复发3例,两组复发率有统计学差异,腹腔镜组复发率低于开放组(P<0.05)。结论开放式手术和腹腔镜手术治疗腹壁切口疝的安全性和有效性相当,但腹腔镜手术具有住院时间短、创伤小等优点。Objective To explore the effects of peritoneoscope and open surgery in the treatment of abdominal wall incisional hernia. Methods The clinical data of 63 patients with abdominal wall incisional hernia admitted to our hospital from January 2007 to September 2016 were analyzed retrospectively and divided into a peritoneoscope group （n=32） and an open group （n=31） according to the operation method. The duration of operation, postoperative length of stay （LOS）, intraoperative amount of bleeding, incidence of postoperative complications, recurrence rate and other data between the two groups were compared. Results There was no significant difference in the intraoperative amount of bleeding between the two groups （P 〉 0.05）, and the postoperative LOS and incidence of postoperative complications in the peritoneoscope group were lower than those in the open group （P 〈 0.05）. There was one case of intestinal fistula during separation of synechia due to close attachment of hernial sac and small intestine. This patient received laparotomy instead. There was no death in the two groups. During the 2-80-month postoperative follow-up visit, there was no recurrence in the peritoneoscope group while there were three cases of recurrence in the open group, showing statistical difference. The recurrence rate in the peritoneoscope group was lower than that in the open group （P 〈 0.05）. Conclusions Open surgery and laparoscopic surgery have equal safety and effects in the treatment of abdominal wall incisional hernia, but the latter has more advantages, such as short LOS and minimal trauma.

关 键 词：腹壁 切口疝 腹腔镜 修补术 开放式手术 

分 类 号：R656[医药卫生—外科学]