小切口辅助腹腔镜手术在巨大造口旁疝修补术中的应用

目的:探讨小切口辅助腹腔镜手术修补巨大造口旁疝的临床效果与手术经验.方法:回顾分析2008年8月至2010年12月为37例巨大造口旁疝患者行小切口辅助腹腔镜手术的临床资料,观察手术时间、隐匿疝、小切口长度、住院时间、切口感染、浆液肿、慢性疼痛、复发率等情况.结果:37例均顺利完成手术,手术时间平均(127.97±18.54) min,小切口长度平均(5.89±1.02) cm,发现隐匿疝12例,术中肠道损伤修补3例,无手术死亡病例.术后平均住院(5.35±1.27)d,术后3例疼痛时间大于3个月,4例发生浆液肿,无一例切口感染.术后随访6 ～ 30个月,无一例复发.结论:小切口辅助腹腔镜手术修补巨大造口旁疝是安全、可靠的,有效减少了术后并发症的发生,达到了腹壁塑性的效果.

The application of laparoscopic hernia repair with a subsidiary mini-incision for large parastomal hernias

Objective: To explore the clinical effect and the experience of laparoscopic hernia repair with a subsidiary mini-incision for large parastomal hernias.Methods: The clinical data of 37 patients with large parastomal hernia who underwent laparoscopic hernia repair with a subsidiary mini-incision from Aug.2008 to Dec.2010 were retrospectively analyzed,and reviewed the operational duration,missed hernia,length of the incision,the length of stay,wound infection,serumal cyst,chronic pain and recurrence.Results: All of the 37 cases underwent smooth operations.The mean operation time was(127.97 ± 18.54) min,and the average length of the incision were(5.89 ± 1.02) cm,and 12 cases of missed hernia were founded in the operation,and 3 cases of intestinal injury were repaired intraoperatively,and there was no operative fatality.The mean postoperative length of stay were(5.35 ± 1.27) d,and 3 case had the postoperative pain lasted 3 months,and 4 case had the postoperative serumal cyst,and there was no incisional infection.All the cases had the follow-up of 6-30 m and no recurrence was observed.Conclusions: Laparoscopic hernia repair with a subsidiary mini-incision could be an effective and safe method.It can reduce the incidence of the postoperative complication.