中国实用外科杂志

中国实用外科杂志 ›› 2025, Vol. 45 ›› Issue (05): 559-563.DOI: 10.19538/j.cjps.issn1005-2208.2025.05.15

• 论著 • 上一篇    下一篇

腹腔镜腹腔内补片修补术治疗复发性切口疝临床疗效分析

杨董超，马骏梁，宋致成，李绍春，李绍杰，顾    岩，唐健雄   

  1. 复旦大学附属华东医院普外科，上海 200040
  • 出版日期:2025-05-01 发布日期:2025-05-28

  • Online:2025-05-01 Published:2025-05-28

摘要： 目的    探讨腹腔镜腹腔内补片修补术（IPOM）在复发性切口疝中应用的临床效果。方法    回顾性分析复旦大学附属华东医院2022年1月至2024年12月行腹腔镜IPOM修补术的110例切口疝病人的临床资料，按术前诊断分为复发组（24例）和初发组（86例）。主要观察指标为术后疝复发率，次要观察指标为手术时间、术中出血量、术后住院天数、引流天数和切口相关并发症。结果    所有纳入研究病人平均随访时间（17.4±9.6）个月。两组病人一般资料、缺损分区、缺损分级比例、美国麻醉医师协会评分分级比例、术后疝复发率、切口相关并发症、住院天数及引流管放置天数等比较，差异无统计学意义（P>0.05）。复发组手术时间［（158.8±60.2）min vs. （132.2±47.7） min，P=0.024）］和术中出血量［（51.2±33.1）mL vs. （34.7±28.6） mL，P=0.018）］多于初发组，差异有统计学意义。结论    腹腔镜IPOM是治疗复发性切口疝的安全有效的选择。

关键词: 切口疝, 复发疝, 腹腔镜腹膜内补片修补术

Abstract: To investigate the clinical outcomes of laparoscopic intraperitoneal onlay mesh (IPOM) repair in the treatment of recurrent incisional hernias. Methods    A retrospective analysis was conducted based on the clinical data of 110 patients who underwent laparoscopic IPOM repair for incisional hernias at Huadong Hospital Affiliated to Fudan University between January 2022 and December 2024. They were divided into the recurrent group (n=24) and the primary group (n=86), according to the preoperative diagnosis.The primary outcome was postoperative hernia recurrence rate, while secondary outcomes included operative time, intraoperative blood loss, postoperative hospital stay, duration of drainage, and incision-related complications. Results  The average follow-up time for all patients included in the study was (17.4±9.6) months. There were no statistically significant differences between the two groups in terms of general patient data, defect partition, defect grade ratio, American Society of Anesthesiologists score classification ratio, recurrence rate of hernia, incision-related complications, hospital stay, and the number of days with drainage tubes in place (P>0.05). The recurrent group exhibited significantly longer operative time ［(158.8±60.2) min vs. (132.2±47.7) min, P=0.024］ and greater intraoperative blood loss ［(51.2±33.1) mL vs. (34.7±28.6) mL, P=0.018］ compared to the primary group. Conclusion    Laparoscopic IPOM repair is a safe and effective option for treating recurrent incisional hernias.

Key words: incisional hernia, recurrent hernia, laparoscopic intraperitoneal mesh repair