腹壁切口疝的微创外科治疗

<正>腹腔镜切口疝修补术(laparoscopic ventral hernia repair,LVHR)于1993年由LeBlanc等[1]首次报道,其为腹腔内修补法,是一种"后入路"的修补方式,复发率为2%～5%[2]。腹壁     

腹腔镜疝修补术治疗成人腹壁疝效果观察

目的观察腹腔镜疝修补术治疗成人腹壁疝的效果。方法选取2015-10—2017-10间在汝南县中医院接受疝修补术的92例成人腹壁疝患者。对照组行开腹手术,观察组行腹腔镜手术。比较2组治疗效果。结果观察组术中出血量、术后疼痛持续时间、住院时间、切口愈合不良率、腹壁安放补片区疼痛率、C反应蛋白和白介素-6水平等指标均优于对照组,差异均有统计学意义(P0.05)。结论腹腔镜疝修补术治疗成人腹壁疝,不仅可减轻患者机体的炎症反应,而且能降低并发症发生率,疗效确切。     

修补腹壁疝的几点建议

<正>补片修补腹壁疝已是一种广泛使用的手术方法。随着病例的积累、随访时间的延长和随访手段的日趋完整,当前有三个并发症大家必须重视,分     

自体疝囊瓣修补腹壁巨大切口疝

自体疝囊瓣修补腹壁巨大切口疝耿协强樊献军李元地谭建美我院自１９９０年１０月～１９９６年１月收治１２例腹壁切口疝，其中３例巨大切口疝采用自体疝囊瓣修补成功，报告如下。１病例报告例１，女，４７岁。１９９０年５月因腹痛３天行剖腹探查，阑尾切除，术后切口感染...     

补片修补巨大腹壁切口疝80例

目的：探讨巨大腹壁切口疝的补片治疗。方法回顾性分析2003年8月至2013年10月,新疆伊宁市人民医院收治的巨大腹壁切口疝患者80例的临床资料。结果术前提高腹壁顺应性、手术术式、手术操作、引流管的放置、抗生素预防应用、围手术期处理对预后构成影响因素。80例患者均痊愈出院,无严重并发症,复发3例。手术复发率为3．7％。结论应用补片修补腹壁巨大切口疝效果满意,术后恢复快,要重视围手术期处理。     

腹壁切口疝的诊治进展

目的 报道腹壁切口疝的诊治进展。方法 采用文献回顾的方法，对国内、外腹壁切口疝的病因、病理、临床流行病学资料以及诊断和治疗进展加以综述。结果 腹壁切口疝是腹部手术较为常见的并发症，严重影响患者生活质量，致病因素多样，治疗较为复杂。结论 腹壁切口疝重在预防，人工合成材料无张力修补是目前应用广泛、效果良好的治疗手段。     

腹腔镜手术治疗腹壁切口疝现状和趋势

腹壁切口疝是腹部手术后常见的医源性并发症之一,发病率约为3%～29%[1]。切口疝不能自愈,均需要手术治疗。手术方法有单纯缝合修补和无张力修补两种,随着腔镜技术的发展,这两种术式均能在腹腔镜下完成。腹腔镜腹壁切口疝修补术(laparoscopic ventral/incisional hernia repair,LVHR)最早报道于1993年。本文就目前开展的现状以及一些热点问题进行讨论。     

当前腹壁切口疝治疗的几点建议

最近笔者收到了美国华盛顿大学医学院Matthews教授发来的邮件,要求参与一个关于腹壁疝修补手术后补片感染治疗的全球性调查(an expert-based consensus for the treatment of mesh infections after ventral hernia repair)。2008年,在瑞士Suvertta国际疝论坛讨论疝修补后遗症(hernia repair SEQUELAE)时,"感染的危险"是作为重点讨     

腹壁巨大切口疝术前评估及准备

腹壁切口疝是腹部手术后的远期并发症之一,其发生率约为2%～11%,若切口感染疝的发生率可增加至23%[1]。目前,美国1年的切口疝修补手术为20万例左右[2],年龄>65岁的老年病人尤为突出,约占39%[3]。近年来,随着人工合     

腹壁巨大切口疝的治疗进展

腹壁巨大切口疝是腹部手术的常见并发症,手术是治疗切口疝的唯一有效方法.巨大切口疝围手术期应注意治疗局部病灶和预防应用抗生素,并注意评估患者疝内容物还纳后的耐受能力.疝环难以关闭是巨大切口疝修补手术中的难点之一,而用腹壁分离技术关闭疝环是可行的.关闭疝环后,应使用生物材料进行补片修补.补片修补的手术方式很多,其中三明治修补术似乎更优越.本文主要对目前腹壁巨大切口疝的治疗进展作一综述.     

Surgical treatment of postop abdominal wall hernia

Two methods of combined plasty of postoperative abdominal wall hernia (PAWH), based on biochemical conception of pathogenesis of the disease, were proposed. Application of the methods had allowed to close the defect of any size of anterior abdominal wall. For the 1996-2001 period 221 patients with large, huge and giant PAWH were operated. Local and general complications in 29 (13.1%) patients had occurred, one patient died. Result of treatment in term up to 6 years was studied, recurrency of the disease was not revealed.     

创伤性腹壁疝的诊治经验

目的 探讨创伤性腹壁疝的临床诊断标准和治疗方案.方法 回顾性分析1971-2004年收治的11例创伤性腹壁疝的临床资料.皮下型疝8例,其中嵌顿型疝2例,难复性疝1例;肌间隙型疝2例,其中嵌顿和绞窄1例;腹膜后型1例.11例中单纯性疝3例,伴腹内其他脏器损伤的复合性疝8例.结果 症状出现至就诊时间3 h至5个月,11例中8例误诊.5例错误选择切口,1例误将疝出肠襻切开.误诊8例中3例修补失败,2例未发现缺损行二次手术.结论 对创伤性腹壁疝只有做出正确的诊断,选择正确的手术时机,确定恰当的手术切口,制定合理的修补方法,方可获得良好的治疗效果.     

The method of treatment choice for the abdominal wall hernia

Experience of treatment of 975 patients with postoperative and recurrent abdominal wall hernia (AWH) and of 1473 patients with inguinal hernia was summarized. Intraoperative classification of Shevrel and Rets for AWH and of Gilbert and Rutkov for inguinal hernia were applied. The conventional methods of plasty, using local tissues, were performed up to 1998 in 648 patients with AWH and in 983--with inguinal hernia. Synthetic implants were used since 1999 in 327 patients with AWH and in 181--with inguinal hernia. In application of conventional methods recurrency had occurred after plasty for AWH in 26.6% and for inguinal hernia--in 5.8% of observations; hernial recurrency was not noted after usage of the modern plasty methods.     

Traumatic abdominal wall hernia

Traumatic abdominal hernias are uncommon. A case is presented of a 49-year-old man who struck his abdomen on the handlebars of a snowmobile. Local pain, bruising, and reducible swelling with cough impulse suggest the diagnosis. Lateral or oblique X-rays and use of contrast material are recommended. Differentiation from a preexisting hernia may be important medicolegally. Incision, if necessary, should be very carefully made. In the present case surgical repair was followed by uneventful recovery.     

Traumatic abdominal wall hernia

Traumatic herniation of the abdominal wall is an unusual injury. Early morbidity is related to associated intra-abdominal organ injuries which are common. Late complications due to intestinal incarceration and strangulation can occur. Immediate celiotomy is necessary for hernia reduction and repair and for evaluation of intra-abdominal organ injury. This approach obviates any late complications.     

Traumatic hernia of the abdominal wall

Traumatic hernia of the abdominal wall is unusual and even more so the complete avulsion of muscles from the costal arch. While it is usual to search carefully for diaphragmatic hernia during laparotomy for blunt abdominal trauma, traumatic hernia of the abdominal wall of this nature can be easily overlooked. One such case in a child is presented where the diagnosis was not made at the initial laparotomy following blunt abdominal injury received in a road traffic accident. We believe bilateral avulsion of all the abdominal wall muscles from the costal arch has not been reported before.