摘要
目的 总结应用杂交技术修补巨大复杂性腹壁切口疝的技术操作要点及其疗效。方法 对中山大学孙逸仙纪念医院胃肠外科2008年9月至2011年2月应用杂交技术修补巨大复杂腹壁切口疝的28例病人的临床资料进行回顾性分析。结果 手术均顺利完成。手术时间76～162（102±21）min。疝环缺损直径10～25（15.5±3.2）cm。疝缺损面积64～224（118.0±42.1）cm2。小切口长4～8（6.1±0.8）cm。7例（25.0%）病人术中发现隐匿性疝缺损。术后明显腹胀者3例（10.7%），血清肿2例（7.1%），血肿1例（3.6%），8例（28.6%）术后早期术区腹壁疼痛。均保守治愈。术后住院天数为3～13（4.9±1.8）d。无切口感染、术中及术后大出血、肠管损伤、心肺衰竭等严重并发症。随访6～51（25.1±5.6）个月，复发1例（3.6%）。结论 应用杂交技术修补腹壁切口疝安全可靠，疗效确切，术后恢复快。尤其适用于复杂、巨大腹壁切口疝者，值得临床推广。
Objective To evaluate the operational skills and efficacy of a combined laparoscopic and open technique （hybrid technique） for the repair of large complicated incisional hernia. Methods The clinical data of 28 cases of large complicated incisional hernia underwent hybrid repair technique from September 2008 to February 2011 in Sun Yat-sen Memorial Hospital of Sun Yat-sen University were analyzed retrospectively. Results All cases were operated on successfully and recovered uneventfully. The operating time was 76-162 （102±21）min. The length of incision was 4-8 （6.1±0.8）cm. The diameter of the hernia ring was 10-25 （15.5±3.2）cm and the size of hernia ring was 64-224（118.0±42.1）cm2. Missed hernia was detected in 7 cases （25%） intraoperatively and was repaired during the procedure. Postoperative complications included abdominal pain （n=8, 28.6%）, abdominal distension （n=3, 10.7%）, seroma （n=2, 7.1%） and hematoma （n=1, 3.6%）. All of them were cured with conservative treatment. Postoperative hospital time was 3-13 （4.9±1.8） days. No patient developed wound infection, massive haemorrhage, intestinal injury or cardiorespiratory function failure. One recurrent case was observed during a mean （25.1±5.6） months follow-up period. Conclusion Hybrid technique for incisional hernia repair is a safe and effective procedure especially suitable for patients with large complicated hernias, which deserves to be popularized.
出处
《中国实用外科杂志》
CSCD
北大核心
2013年第12期1051-1053,共3页
Chinese Journal of Practical Surgery
关键词
切口疝
杂交技术
腹腔镜
incisional hernia
hybrid technique
laparoscope
