完全腔镜下腹直肌后修补术治疗产后腹直肌分离经验分享  

Experience sharing of totally extraperitoneal sublay repair under complete endoscopy for diastasis rectus abdominis after delivery

作　　者：李斌[1,2] 康欣[2] 宋应寒 雷文章[1] Bin Li;Xin Kang;Yinghan Song;Wenzhang Lei(Department of Gastrointestinal Surgery,West China Hospital of Sichuan University,Chengdu 610000,Sichuan,China;Department of General Surgery,West China(Airport)Hospital Sichuan University,Chengdu 610299,Sichuan,China)

机构地区：[1]四川大学华西医院胃肠外科,成都610000 [2]四川大学华西空港医院普外科,成都610299

出　　处：《中华疝和腹壁外科杂志（电子版）》2024年第2期208-213,共6页Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition)

基　　金：四川省科技厅重点项目(2022YFS0230)。

摘　　要：目的探讨完全腹腔镜下腹直肌后修补手术(TES)微创治疗产后腹直肌分离(DRA)的临床疗效。方法对2022年3—7月四川大学华西医院收治的4例产后DRA患者的临床资料进行分析,患者均行TES术,腹直肌后置入15 cm×20 cm聚丙烯疝修补网片加强修复,无需钉枪固定,无需防粘连补片。观察患者术中及术后恢复情况,采用门诊、微信及电话联系进行术后随访,记录患者术后恢复及并发症发生情况。结果4例患者均顺利完成完全TES手术,无中转开腹,2例合并脐疝,1例合并白线疝,平均手术时间168 min,术后第1天数字分级法疼痛评分平均为2分,术后拔除引流管时间约2.5 d,术后无并发症发生,术后平均住院时间为3.5 d。4例患者均获得术后随访,随访时间分别为术后1、3、6、9、12个月,无复发病例,无并发症发生。结论TES治疗产后DRA是安全、经济、有效的。Objective To investigate the clinical effect of minimally invasive totally extraperitoneal sublay(TES)repair for treatment of diastasis rectus abdominis(DRA)after delivery.Methods The clinical data of four postpartum DRA patients treated at West China Hospital of Sichuan University from March to July 2022 were analyzed.All patients underwent TES surgery,with a 15 cm×20 cm polypropylene hernia repair mesh placed posterior to the rectus abdominis for reinforcement repair,without the need for staple gun fixation or anti-adhesion mesh.Patients'intraoperative and postoperative recovery conditions were observed.Postoperative follow-up was conducted through outpatient visits,WeChat,and telephone contacts to record patients'recovery and the occurrence of complications.Results All four patients successfully completed the TES procedure without conversion to open surgery.Two cases had concurrent umbilical hernias,and one had a linea alba hernia.The average surgery duration was 168 minutes,with a postoperative day 1 numeric pain rating scale average score of 2,and an approximate 2.5 days until drainage tube removal.No postoperative complications occurred,and the average post-hospital stay was 3.5 days.All 4 patients were followed up postoperatively at 1,3,6,9,and 12 months,with no cases of recurrence or complications.Conclusion TES is safe,economical and effective in treating DRA after delivery.

关 键 词：腹直肌分离 腹直肌后修补 腹腔镜 疝修补术 补片 

分 类 号：R714.6[医药卫生—妇产科学]