同期腹腔镜手术治疗病态性肥胖合并腹壁疝7例疗效分析  

Therapeutic efficacy of concurrent laparoscopic sleeve gastrectomy with ventral hernia repair:An analysis of 7 cases

作　　者：吴立胜 李煜[1] 余建伟 吴志海 WU Li-sheng;LI Yu;YU Jian-wei(Department of Hernia and Bariatric Metabolic Surgery,the First Affiliated Hospital of University of Science and Technology of China,Hefei 230001,China;不详)

机构地区：[1]中国科学技术大学附属第一医院疝及减重代谢外科,安徽合肥230001 [2]南陵县医院普通外科,安徽芜湖241300

出　　处：《中国实用外科杂志》2021年第4期405-408,共4页Chinese Journal of Practical Surgery

基　　金：吴阶平医学基金会临床科研专项资助基金(No.320.6750.2021-03-3)。

摘　　要：目的探讨病态性肥胖合并腹壁疝病人行同期腹腔镜胃袖状切除术(LSG)和腹壁疝修补术的临床疗效。方法回顾性分析2018年1月至2020年7月中国科学技术大学附属第一医院疝与减重代谢外科中心和芜湖市南陵县医院普外科收治的同期行LSG+腹壁疝修补术的7例病态性肥胖合并腹壁疝病人的临床资料,BMI为38.2(33.5~42.2),疝环缺损最大径为5(2~8)cm。术后随访观察疗效。结果7例病人均顺利完成手术,其中6例行LSG+腹腔内补片置入术(IPOM),1例行LSG+开放肌后间隙补片修补术(Sublay)。手术时间为150(120~170)min。术后未发生胃漏、腹腔感染等严重并发症,1例病人出现腹壁血清肿。随访10(7~35)个月,均未出现迟发性胃漏、迟发性补片感染及腹壁疝复发等并发症,BMI下降7.7(4.3~22),体重下降30(20~43)kg。结论对于合并中等大小切口疝的病态性肥胖(BMI 35~43)病人,同期行LSG和疝修补术安全有效。Objective To investigate the clinical efficacy of concurrent laparoscopic sleeve gastrectomy with ventral hernia repair for morbid obesity patients with ventral hernia.Methods The clinical data of 7 patients with ventral hernia and morbid obesity who underwent concurrent laparoscopic sleeve gastrectomy with ventral hernia repair from January 2018 to July 2020 in the Center of Hernia and Bariatric Metabolic Surgery of the First Affiliated Hospital of University of Science and Technology of China and the Department of General Surgery of Nanling County Hospital were analyzed retrospectively.Those patients had a BMI of 38.2(33.5 to 42.2)and a hernia ring defect of 5(2 to 8)cm,and the patients were followed up.Results Seven patients were performed surgery successfully.Concurrent laparoscopic sleeve gastrectomy with IPOM was performed in 6 patients and open sublay in 1 patient.No serious complication such as gastric leakage and abdominal infection was found in all 7 patients after operation.Postoperative seroma of the abdominal wall occurred in one patient.The operation time was 120 to 170(median 150)min.No serious complication such as gastric leakage and abdominal infection occurred.One patient developed seroma of abdominal wall.The median follow-up was 10 months(7 to 35 months).No delayed gastric leakage,delayed mesh infection and recurrence of ventral hernia were found in the 7 patients.Weight loss was 20 to 43(median 30)kg.BMI decreased 7.7(4.3 to 22.0).Conclusion Concurrent laparoscopic sleeve gastrectomy with mesh repair of ventral hernia is safe and effective for morbidly obese patients with BMI of 35 to 43 and moderate incisional hernia.

关 键 词：病态性肥胖 腹壁疝 胃袖状切除术 腹腔镜 疝修补术 

分 类 号：R6[医药卫生—外科学]