中小型脐疝的外科治疗。一个外科医生的经历

E. Élthes, D. Sala, R. Neagoe, János Székely, M. Dénes
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引用次数: 0

摘要

摘要简介:微创外科手术已成为当今的常规干预措施,即使是小脐疝也代表了一种有效的治疗选择,提供了良好的术后和美学效果。目的:探讨中小型脐疝最合适的微创治疗方案。材料和方法:我们对50例中小型脐疝(<4 cm)患者进行了前瞻性研究。所有患者均受益于微创补片植入手术。根据手术方式,分为两大组:A组-开放手术入路患者(n = 24)和B组-腹腔镜手术患者(n = 26)。对临床、手术、术后及随访资料进行分析。结果:经脐开放入路补片置换与手术时间(p = 0.0359)、止痛药(p = 0.0461)和抗凝血剂(p = 0.0404)的使用显著缩短相关。该组住院时间(p = 0.0001)和费用(p = 0.0005)也显著降低。随访6个月,未见复发,术后疼痛及患者职业重返方面无明显差异。开放组患者对术后瘢痕的满意度较高。结论:腹侧补片技术是一种安全有效的治疗中小型脐疝的方法。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Proper Surgical Treatment of Small and Medium Size Umbilical Hernias. A Single Surgeon Experience
Abstract Introduction: Minimally invasive surgical procedures have become routine interventions nowadays and represent an effective therapeutic option even for small umbilical hernias, providing favorable postoperative and aesthetic results. Aim of study: To determine the most appropriate minimally invasive treatment option for small and medium size umbilical hernias. Materials and methods: We conducted a prospective study on 50 patients with small or medium umbilical hernia (<4 cm). All patients benefited of minimal invasive surgery with mesh implantation. Depending on the surgical procedure, two major groups were defined: group A – patients with open surgical approach (n = 24) and group B – patients undergoing laparoscopic surgery (n = 26). Clinical, surgical, postoperative, and follow-up data were analyzed. Results: Mesh replacement via open approach through the umbilicus was associated with significantly reduced surgical time (p = 0.0359), administration of painkillers (p = 0.0461), and use of anticoagulants (p = 0.0404). Hospital stays (p = 0.0001) and costs (p = 0.0005) were also significantly lower in this group. After 6 months of follow-up, no recurrence was observed, and no significant differences were detected regarding postoperative pain and the patients’ professional reintegration. Patient satisfaction regarding postoperative scar was superior in the open group. Conclusion: The present study indicates that the ventral patch technique is a safe and effective method for the treatment of small and medium size umbilical hernias.
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