腹腔镜与开放式无张力修补术治疗腹壁疝临床对比研究

Chinese Journal of Practical Surgery ›› 2008, Vol. 28 ›› Issue (12) : 1040-1043.

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Chinese Journal of Practical Surgery ›› 2008, Vol. 28 ›› Issue (12) : 1040-1043.
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Abstract

Clinical control study of laparoscopic procedures vs open mesh repair for ventral hernias LI Jian-wen, XIE Yi-sheng, QIU Ming-yuan, et al. Department of General Surgery, Ruijin Hospital of Shanghai Jiao Tong University, Shanghai Minimally Invasive Surgery Centre, Shanghai 200025, China. Correspongding anthor: MAO Zhi-hai, E-mail:zhihaimao@163.com Abstract Objective To estimate the laparoscopic ventral hernia repair(LVHR), focusing on the safety and efficiency of the operations. Methods The clinical data of 68 patients with ventral hernias (defect≤20cm) performed hernia reparing between January 2007 and August 2008 at Ruijin Hospital of Shanghai Jiao Tong University were analyzed retrospectively. Results Thirty-one patients underwent laparoscopic repair (LVHR), and 37 patients underwent open mesh repair (OVHR). The clinical outcome was determined by a median follow-up of 11 months(1~21 months) for the two groups. No significant differences were noticed between the two groups in age, sex, body mass index (BMI), and hernia size. The mean operative time was (60.5±17.7)min for LVHR patients and (75.5±30.3)min for OVHR patients (P=0.017). The mean postoperative hospital stay was (6.2±2.5)d for LVHR patients and (9.6±8.0)d for OVHR patients (P=0.026). 96.8% of patients (30/31) were able to return to usual activity in 2 weeks for LVHR and 78.4% of patients (29/37) for OVHR (P=0.026). LVHR patients felt less pain in the first day after operation (P=0.018), and there were no significant differences in visual-analogue pain scores between the two groups afterward. Complications occurred in 19.4 % of LVHR patients and 24.3 % of OVHR patients (P =0.623) with a recurrence rate of 3.2% in LVHR and 5.6% in OVHR patients (P =1.000). The mean cost was (18334±5336) yuan RMB for LVHR patients and (9508±9222) yuan RMB for OVHR patients (P=0.000). Conclusion The short-term results indicate that laparoscopic technique is safe and effective for ventral hernia repairing with hernia defect less than 20cm.

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ventral hernia / laparoscope / hernia repair

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