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首页> 外文期刊>Surgical Endoscopy >Incisional hernias after laparoscopic vs open cholecystectomy.
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Incisional hernias after laparoscopic vs open cholecystectomy.

机译：腹腔镜与开腹胆囊切除术后的切口疝。

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BACKGROUND: The aim of this study was retrospectively to compare the incidence of incisional hernia formation at trocar sites in laparoscopic cholecystectomy with that after conventional open cholecystectomy. METHODS: In all, 271 patients with cholelithiasis underwent either laparoscopic cholecystectomy (LC group, n = 142) or open cholecystectomy (OC group, n = 129). In the OC group, the surgical approach was to use a right subcostal incision in 20.2%, right transrectal laparotomy in 73.6%, and midlaparotomy in 6.2%. Laparotomy closure was performed by continuous absorbable suture for the peritoneum and discontinuous absorbable stitches for muscle and fascia. Laparoscopic access was achieved by use of four trocars (two 10 mm and two 5 mm). Umbilical port closure was performed by suture of fascia using discontinuous stitches. Closure of the remaining ports was performed by suture of the skin. RESULTS: Both patient groups were statistically similar with respect to general risk factors. Follow-up was performed in 84 (65.1%) OC and 123 (86.6%) LC patients and ranged from 2 to 10 years (mean, 8 years) and 1 to 5 years (mean, 3 years) respectively. Five (5.9%) OC and two (1.6%) LC patients developed incisional hernias, although the difference between groups was not significant. All hernias in OC patients appeared after transrectal laparotomy. The LC hernias appeared at the umbilical port, and one of the patients developed an additional xiphoides port-associated hernia. CONCLUSIONS: The laparoscopic technique showed a lower (although not significantly) incidence of incisional hernias than the open procedure.
机译：背景：本研究的目的是回顾性比较腹腔镜胆囊切除术与常规开放性胆囊切除术在套管针部位切开疝的发生率。方法：总共271例胆石症患者接受了腹腔镜胆囊切除术（LC组，n = 142）或开腹胆囊切除术（OC组，n = 129）。在OC组中，手术方法是使用右肋下切口20.2％，右经腹腔镜开腹术73.6％，开腹剖腹术6.2％。通过连续的腹膜可吸收缝合线和肌肉和筋膜的不连续吸收缝线进行开腹手术。通过使用四个套管针（两个10毫米和两个5毫米）实现了腹腔镜检查。通过使用不连续缝线缝合筋膜来进行脐带口闭合。通过缝合皮肤来关闭剩余的端口。结果：两组患者的一般危险因素在统计学上相似。随访了84例（65.1％）OC患者和123例（86.6％）LC患者，随访时间分别为2至10年（平均8年）和1至5年（平均3年）。尽管两组之间的差异不显着，但有五名（5.9％）OC和两名（1.6％）LC患者出现了切口疝。经直肠剖腹手术后，OC患者的所有疝均出现。 LC疝气出现在脐带端口，其中一名患者发展了另外的剑突相关的疝气。结论：腹腔镜技术显示切开疝的发生率比开放手术低（尽管不明显）。

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