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中华疝和腹壁外科杂志(电子版) ›› 2023, Vol. 17 ›› Issue (02) : 233 -236. doi: 10.3877/cma.j.issn.1674-392X.2023.02.024

所属专题: 经典病例

病例分析

腹腔镜阑尾切除术后早发型Trocar部位疝一例并文献复习
苏进1, 尹晖明2,()   
  1. 1. 412000 湖南省,株洲市中心医院普外科
    2. 410005 长沙,湖南中医药大学第二附属医院普外科
  • 收稿日期:2022-07-11 出版日期:2023-04-18
  • 通信作者: 尹晖明

Early-onset Trocar hernia following laparoscopic appendectomy:a case report and review of the literature

Jin Su1, Huiming Yin2()   

  • Received:2022-07-11 Published:2023-04-18
  • Corresponding author: Huiming Yin
引用本文:

苏进, 尹晖明. 腹腔镜阑尾切除术后早发型Trocar部位疝一例并文献复习[J]. 中华疝和腹壁外科杂志(电子版), 2023, 17(02): 233-236.

Jin Su, Huiming Yin. Early-onset Trocar hernia following laparoscopic appendectomy:a case report and review of the literature[J]. Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition), 2023, 17(02): 233-236.

近20年来腹腔镜技术及机器人手术广泛应用于外科领域,归因于其创伤小、恢复快、出血少、住院时间短、术中术后并发症发生率低等优点[1]。切口疝是腹部手术术后较为常见的并发症,和开放手术相比,腹腔镜术后切口疝的发生率明显降低[2]。Trocar部位疝(Trocar site hernia,TSH)是切口疝的一种特殊类型,TSH的发生率低,约为0~5.2%[3],国内一项单中心研究统计近20年腹腔镜妇科手术术后TSH总体发生率为0.016%[4]。TSH一旦发生,不能自愈,而且可潜在引起肠梗阻、肠坏死等严重并发症。本文旨在探讨TSH发生的危险因素、筋膜缺损关闭选择和方法、诊断、鉴别诊断及治疗,为临床实践提供参考。

图1 Trocar部位疝并小肠梗阻腹部CT注:可见部分小肠肠管嵌顿于左下腹壁切口,合并近端小肠梗阻。
[1]
Schiphorst AH, Verweij NM, Pronk A, et al. Non-surgical complications after laparoscopic and open surgery for colorectal cancer-a systematic review of randomised controlled trials[J]. Eur J Surg Oncol, 2015, 41(9): 1118-1127.
[2]
Kössler-Ebs JB, Grummich K, Jensen K, et al. Incisional hernia rates after laparoscopic or open abdominal surgery-a systematic review and meta-analysis[J]. World J Surg, 2016, 40(10): 2319-2330.
[3]
Swank HA, Mulder IM, la Chapelle CF, et al. Systematic review of trocar-site hernia[J]. Br J Surg, 2012, 99(3): 315-323.
[4]
Zhu YP, Liang S, Zhu L, et al. Trocar-site hernia after gynecological laparoscopic surgery: a 20-year, single-center experience[J]. Chin Med J(Engl), 2019, 132(22): 2677-2683.
[5]
Tonouchi H, Ohmori Y, Kobayashi M, et al. Trocar site hernia[J]. Arch Surg, 2004, 139(11): 1248-1256.
[6]
Chorti A, AbuFarha S, Michalopoulos A, et al. Richter's hernia in a 5-mm trocar site[J]. SAGE Open Med Case Rep, 2019, 7: 1-4
[7]
Wu Z, Wang S, Yuan S, et al. Clinical efficacy and safety of somatostatin in the treatment of early postoperative inflammatory small bowel obstruction: a protocol for systematic review and meta analysis[J]. Medicine(Baltimore), 2020, 99(20): e20288.
[8]
Lambertz A, Stüben BO, Bock B, et al. Port-site incisional hernia - a case series of 54 patients[J]. Ann Med Surg(Lond), 2017, 14: 8-11.
[9]
Nacef K, Chaouch MA, Chaouch A, et al. Trocar site post incisional hernia: about 19 cases[J]. Pan Afr Med J, 2018, 29: 183.
[10]
Nofal MN, Yousef AJ, Hamdan FF, et al. Characteristics of trocar site hernia after laparoscopic cholecystectomy[J]. Sci Rep, 2020, 10(1): 2868.
[11]
Hoyuela C, Juvany M, Guillaumes S, et al. Long-term incisional hernia rate after single-incision laparoscopic cholecystectomy is significantly higher than that after standard three-port laparoscopy: a cohort study[J]. Hernia, 2019, 23(6): 1205-1213.
[12]
Wells A, Germanos GJ, Salemi JL, et al. Laparoscopic surgeons' perspectives on risk factors for and prophylaxis of trocar site hernias: a multispecialty national survey[J]. JSLS, 2019, 23(2): e2019. 00013.
[13]
Cho WT, Yoo T, Kim SM. Is the 8-mm robotic port safe? a case of trocar site hernia after robotic cholecystectomy using the da Vinci Xi system[J]. Wideochir Inne Tech Maloinwazyjne, 2019, 14(1): 137-140.
[14]
Buffone A, Lo Bianco S, Cavallaro D, et al. Epigastrium: unusual site of incisional hernia from a 5 mm trocar[J]. Ann Ital Chir, 2017, 6: S2239253X17027074.
[15]
Liot E, Bréguet R, Piguet V, et al. Evaluation of port site hernias, chronic pain and recurrence rates after laparoscopic ventral hernia repair: a monocentric long-term study[J]. Hernia, 2017, 21(6): 917-923.
[16]
Owens M, Barry M, Janjua AZ, et al. A systematic review of laparoscopic port site hernias in gastrointestinal surgery[J]. Surgeon, 2011, 9(4): 218-224.
[17]
Micelli E, Russo E, Mannella P, et al. Severe bowel incarceration in an eight-millimeter left-lateral trocar site after robot-assisted laparoscopic colposacropexy: a case report[J]. Case Rep Womens Health, 2019, 24: e00151.
[18]
Qu T, Li R, Kothari AN, et al. Acute appendicitis within a robotic port-site hernia: a case report[J]. J Surg Case Rep, 2020, 2020(2): rjz399.
[19]
Pereira N, Hutchinson AP, Irani M, et al. 5-millimeter trocar-site hernias after laparoscopy requiring surgical repair[J]. J Minim Invasive Gynecol, 2016, 23(4): 505-511.
[20]
Christie MC, Manger JP, Khiyami AM, et al. Occult radiographically evident port-site hernia after robot-assisted urologic surgery: incidence and risk factors[J]. J Endourol, 2016, 30(1): 92-96.
[21]
Cisano C, Sapienza P, Crocetti D, et al. Z-entry technique reduces the risk of trocar-site hernias in obese patients[J]. Ann R Coll Surg Engl, 2016, 98(5): 340-341.
[22]
Donmez T, Ozcevik H, Sunamak O, et al. Efficacy and reliability of the use of a needle grasper to prevent trocar site hernia[J]. Wideochir Inne Tech Maloinwazyjne, 2018, 13(4): 477-484.
[23]
Kawai H, Misawa T, Sasaya K, et al. Dual-hemostat port closure technique with customized surgical suture after laparoscopic cholecystectomy: single-center experience[J]. Asian J Endosc Surg, 2020, 13(1): 83-88.
[24]
Tavassoli A, Bagheri R, Feizzadeh B, et al. Fascial repair of laparoscopic ports with allis-hemostat technique[J]. Indian J Surg, 2015, 77(2): 245-247.
[25]
Lasheen AE, Safwat K, Elsheweal A, et al. Effective, simple, easy procedure for laparoscopic port closure in difficult cases[J]. Ann Med Surg(Lond), 2016, 10: 36-40.
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