腹腔镜下腹壁肌后修补术治疗腹壁疝疗效分析  

Analysis of the Efficacy of Laparoscopic Posterior Abdominal Wall Muscle Repair for Abdominal Wall Hernia

作　　者：王涛[1] 王平江 徐栋 WANG Tao;WANG Ping-jiang;XU Dong(General Surgery Department,Zibo Central Hospital,Zibo,Shandong,255036,China)

机构地区：[1]淄博市中心医院普通外科,山东淄博255036 [2]淄博市市立医院普外一科,山东淄博255400

出　　处：《黑龙江医学》2023年第12期1424-1427,共4页Heilongjiang Medical Journal

摘　　要：目的:探讨应用腹腔镜下腹壁肌后修补术(ESR)治疗腹壁疝的临床疗效。总结手术操作步骤及相关技术要点,分析其临床应用效果和价值。方法:选取2017年11月—2019年10月淄博市中心医院、淄博市市立医院收治的26例应用ESR手术治疗的腹壁疝患者,手术操作均按照手术规范执行。结果:26例患者在腹腔镜下腹壁肌后放置补片加强修补,手术过程顺利,无1例中转开放。手术时间为(125.6±33.24)min。术后第2 d开始进食。术后72 h视觉模拟疼痛评分(VAS)为(2.26±0.92)分。住院时间为(5.92±1.87)d。术后18例放置闭式负压引流管,时间为(6.22±3.67)d。术后早期疼痛不适3例,早期出现腹胀不适2例,浅表手术部位切口感染1例,术区出现血清肿3例,均经非手术治疗后好转。术后随访患者时间为(4.42±2.08)个月,无疝复发、出血、补片感染、肠瘘、慢性疼痛(VAS>3分,时间>3个月)等严重并发症。结论:ESR手术在治疗腹壁疝方面安全有效,患者术后恢复快,具有较高的临床应用价值。Objective:The clinical efficacy of laparoscopic endoscopic sublay repair(ESR)in the treatment of abdominal wall hernia was investigated.The surgical procedures and related technical points were summarized,and the clinical application effect and value were analyzed.Methods:A total of 26 patients with abdominal wall hernia who were treated with ESR surgery in our hospital from November 2017 to October 2019 were selected.The surgical operations were performed according to the surgical standards.Results:26 patients underwent laparoscopic abdominal wall reinforcement repair with mesh placed behind the muscle,the operation was smooth,and no one case was converted to open.The operation time was(125.6±33.24)min.Food intake began on day 2 after surgery.Visual analog pain score(VAS)72 h after surgery was(2.26±0.92)points.The length of hospitalization was(5.92±1.87)d.Postoperatively,closed negative pressure drains were placed in 18 cases for(6.22±3.67)d.There were 3 cases of early postoperative pain and discomfort,2 cases of early bloating and discomfort,1 case of superficial surgical site incision infection,and 3 cases of seroma in the operative area,all of which improved after non-operative treatment.The postoperative follow-up of patients was(4.42±2.08)months without serious complications such as hernia recurrence,bleeding,patch infection,intestinal fistula,or chronic pain(VAS>3 points for>3 months).Conclusion:ESR surgery is safe and effective in the treatment of abdominal wall hernia,and patients recover quickly after surgery,which has high clinical application value.

关 键 词：腹壁疝 腹腔镜下疝修补术 微创 

分 类 号：R605[医药卫生—外科学]