腹腔镜经腹Sublay联合自固定补片治疗原发性腰疝的疗效分析  

Laparoscopic transabdominal sublay with self-fixation patch in primary lumbar hernia repair

作　　者：唐新亚 张建松 梁园园 侯森 时永 TANG Xin-ya;ZHANG Jian-song;LIANG Yuan-yuan(Department of Hernia and Abdominal Wall Surgery,Xuchang Central Hospital Affiliated to Henan University of Science and Technology,Xuchang 461000,China)

机构地区：[1]河南科技大学附属许昌市中心医院疝和腹壁外科,河南许昌461000

出　　处：《腹腔镜外科杂志》2022年第9期641-644,共4页Journal of Laparoscopic Surgery

摘　　要：目的:探讨腹腔镜经腹Sublay联合自固定补片治疗原发性腰疝的安全性、有效性。方法:回顾分析2017年1月至2022年1月收治的20例原发性腰疝患者的临床资料,收集围手术期及术后随访相关指标。20例患者中男11例,女9例;平均(59.3±8.3)岁;体重指数平均(24.6±1.5)kg/m^(2)。腹部CT检查证实均为上腰疝,左侧12例,右侧8例;疝内容物18例为腹膜外脂肪,2例为结肠;疝环直径(2.0±0.7)cm。结果:腹腔镜经腹Sublay术式均顺利完成,无中转开腹及术中并发症发生。手术时间平均(64.1±8.7)min;出血量平均(8.5±3.1)mL。术后第1天、第14天疼痛视觉模拟评分分别为1(1,2)分、0(0,1)分,差异有统计学意义(P<0.05)。术后平均住院(3.8±1.0)d,术后无血清肿、感染等并发症发生。随访期间,4例患者有局部不适感,经对症处理术后1个月症状消失;术后1个月,患者疼痛评分为0分;均无慢性疼痛与复发。结论:腹腔镜下经腹Sublay联合自固定补片治疗原发性腰疝是安全、有效的。Objective:To explore the safety and effectiveness of laparoscopic transabdominal sublay repairing with self-gripping mesh in primary lumbar hernia.Methods:Clinical data of twenty patients with primary lumbar hernia from Jan.2017 to Jan.2022 were retrospectively analyzed.Related perioperative and postoperative follow-up data were collected.There were 20 patients(11 males and 9 females),the mean age was(59.3±8.3)years,and the mean body mass index was(24.6±1.5)kg/m^(2).All cases were primary s uperior lumbar hernias confirmed by whole-abdomen CT.There were 12 cases on the left side and 8 cases on the right side.The c ontents of hernia were extraperitoneal fat in eighteen cases and colon in two cases.The mean lumbar defect was(2.0±0.7)cm.R esults:All patients underwent laparoscopic transabdominal sublay surgery with self-gripping mesh.The surgical procedure was completed s uccessfully without conversion to open surgery and any intraoperative complications.The mean operation time was(64.1±8.7)min a nd the mean blood loss was(8.5±3.1)mL.The mean pain visual analogue score on post-operative day 1 and post-operative day 14 were 1(1,2)and 0(0,1)respectively(P<0.05).The mean postoperative hospital stay was(3.8±1.0)d.There were no postoperative complications such as seroma and infection.Four patients had local discomfort which disappeared after symptomatic therapy;the pain score of all patients was 0 in one month postoperatively.No chronic pain or recurrence were found during the follow-up period.Conclusions:Laparoscopic transabdominal sublay combined with self-fixating mesh is a safe and effective method for primary lumbar hernia repairing.

关 键 词：原发性腰疝 腹腔镜检查 经腹Sublay 自固定补片 

分 类 号：R656.2[医药卫生—外科学]