腹腔镜肌后间隙修补腹直肌分离17例临床分析  

The Clinical efficacy of laparoscopic retromuscular repair for rectus diastasis:An analysis of 17 cases

作　　者：范国勇[1] 雷秋成[2] 姚干[1] 张庆峰[1] 邓旭明 段巧斌 FAN Guo-yong;YAO Gan;ZHANG Qing-feng(Department of Hernia and Abdominal Wall Surgery,the First People's Hospital of Foshan,Foshan 528000,China)

机构地区：[1]佛山市第一人民医院疝和腹壁外科,广东佛山528000 [2]佛山市第一人民医院肝脏外科,广东佛山528000

出　　处：《中国实用外科杂志》2023年第7期803-806,810,共5页Chinese Journal of Practical Surgery

基　　金：广东省医学科学技术研究基金项目(No.B2019235)。

摘　　要：目的分析腹腔镜肌后间隙补片修补腹直肌分离的临床疗效并总结临床经验。方法回顾性分析2018年1月至2021年9月佛山市第一人民医院疝和腹壁外科收治的行腹腔镜肌后间隙补片修补的17例腹直肌分离病人的临床资料。收集病人年龄、性别、BMI、手术时间、腹直肌分离间距、术中出血量、术后并发症、住院时间、复发率等指标,并进行观察随访。结果所有病人均顺利完成手术。手术时间为235(120~375)min,术中出血20(5~60)mL。术前超声或CT检查测量腹直肌间距为(4.82±1.16)cm,术中测量腹直肌间距为(4.76±1.25)cm。17例病人中13例(76.5%)为中度腹直肌分离,4例(23.5%)为重度腹直肌分离。病人住院时间为(5.2±1.7)d,2例(11.8%)病人出现术后皮下血肿。随访30(14~58)个月,无复发。结论腹腔镜肌后间隙修补腹直肌分离安全可行,操作空间稳定,无需防粘连补片,减轻病人经济负担,术后复发率及并发症发生率较低,建议在腹腔镜技术成熟的疝和腹壁外科中心推广。Objective To analyze clinical efficacy of laparoscopic retromuscular repair for rectus diastasis and summarize clinical experience.Methods The clinical data of 17 patients who underwent laparoscopic retromuscular repair with mesh for rectus diastasis admitted to the Department of Hernia and abdominal wall surgery in the First People's Hospital of Foshan from January 2018 to September 2021 were retrospectively analyzed.Age,gender,BMI,operation time,diastasis width,intraoperative blood loss,postoperative complications,length of hospital stay,recurrence rate,and other indicators were collected.Results All patients completed the operation.The operation time was 235(120-375)min,and the intraoperative blood loss was 20(5-60)ml;the diastasis width was(4.82±1.16)cm measured by ultrasound or CT before the operation,while was(4.76±1.25)cm measured during the operation.13(76.5%)patients had moderate rectus abdominis separation.4 patients(23.5%)had severe rectus abdominis separation,the length of hospital stay was(5.2±1.7)days.Postoperative subcutaneous hematoma two occurred in 2(11.8%)patients.Followed up 30(14~58)months,and no recurrence.Conclusion Laparoscopic retro muscular repair for rectus diastasis with mesh is safe and feasible,with stable operation space,no need for anti-adhesion mesh,and can reduce the economic burden of patients.The postoperative recurrence rate and complication rate are low.It is recommended to be popularized in hernia,and abdominal wall surgery centers with mature laparoscopic technology.

关 键 词：腹直肌分离 腹腔镜 肌后间隙修补 补片 

分 类 号：R6[医药卫生—外科学]