腹腔镜巨大切口疝修补术47例

目的探讨腹腔镜巨大切口疝修补术的治疗效果和技术要点。方法回顾性总结2004年3月至2009年6月间在我院进行的47例腹腔镜巨大切口疝修补术患者的资料,并对治疗效果和手术要点进行分析。结果术中2例（4.3%）患者因腹腔严重粘连中转开腹手术,其他患者均在腹腔镜下完成手术,肠管浆膜层损伤2例（4.3%）,手术时间平均为87±25min（56～145min）,无大出血病例。术后2例（4.3%）患者出现复发,1例进行了再次手术;34例患者（72.3%）有不同程度的术区腹壁疼痛,7例（14.9%）患者出现了不同程度的腹胀,但1～3个月后自行好转;2例（4.3%）患者术后出现了呼吸功能不全,经呼吸支持治疗后好转,2例（4.3%）患者出现了较明显的血清肿,经穿刺抽吸后好转。无术后出血、肠瘘或死亡病例。结论腹腔镜巨大切口疝修补术是安全、有效的术式。术中缝合、缩小疝环可以达到更加理想的治疗效果。

Laparoscopic large incisional hernia repair with 47 cases

Objective To evaluate the efficiency of laparoscopic large incisional hernia repair,and investigate the technique of this procedure.Methods The clinical data of the 47 laparoscopic large incisional hernioplasty was retrospectively analysed.Results 2 （4.3%） conversions to open procedure and 2 （4.3%） intestinal injury were observed because of severe adhesions.Mean operation time was 87±25min （56 to145min）.2 （4.3%） recurrences were observed during 1 year follow-up.34 （72.3%） developed pain in operation area after operation;7 （14.9%） developed abdominal distention postoperatively.However,they were better at 3 months follow-up.2 （4.3%） developed respiratory insufficiency who recovered after supporting therapy by respirators.2 （4.3%） developed seroma postoperatively.No bleeding,intestinal fistula or death was observed during the follow-up.Conclusions Laparoscopic large incisional hernia repair was effective and safe.Suture of hernia ring may produce better clinical results.