Topic
LaparoscopicManagementofInfectedMeshAfterLaparoscopicInguinalHerniaRepair
Author
ChowbeyPK,KhullarR,SharmaA,etal
Source
SurgLaparoscEndoscPercutanTech.20Apr9
腔镜腹股沟疝修补术后补片感染少见，处理困难。该作者回顾性分析了5年来（至年）处理此类患者的临床经验。共十例患者（TAPP6例，TEP例），均为腔镜腹股沟疝网片修补术后，并发网片深部感染的患者，作者均再次在腔镜下进行处理。通过切开腹膜，引流脓肿，寻找感染补片并将其分离后，通过0/2mm套管针将其取出。
平均随访时间为20月（至2月），9例患者在随访期内恢复情况良好，没有任何感染临床症状。例患者脓肿复发，需要再次手术引流。术后平均住院时间2.2天（到9天）。有2例患者在补片取出术后复发（分别术后6月，8月）。
作者认为，腔镜下感染的深部补片取出术，损伤更小，恢复更快。避免了深部脓肿经皮引流后的腹壁污染的可能。
LaparoscopicManagementofInfectedMeshAfterLaparoscopicInguinalHerniaRepair.ChowbeyPK,etal.
AbstractPURPOSE:Wepresentourexperiencewith0patientswithinfectedmeshesafterlaparoscopicinguinalherniarepairinwhomweexplantedinfectedmesheslaparoscopically.
METHODS:Onretrospectiveanalysisover5years(to),weidentified0patients(6TAPP/TEP)withlocalizeddeep-seatedmeshinfectionsinwhominfectedmesheswereexplantedlaparoscopically.Peritoneumwasincised,associatedabscessesweredrained,mesheswereidentified,separated,andextractedthrough0/2mmport.
RESULTS:Ninepatientsexperiencedresolutionofsymptomsafterweeksofsurgicalinterventionandremainedasymptomaticatmeanfollow-upof20months(range,to2mo).Onepatientwithrecurrentabscessrequiredsurgicaldrainagetwice.Meanhospitalstaywas2.2days(range,to9d).Twopatientsdevelopedrecurrentherniaat6and8monthsaftermeshexplantation.
CONCLUSIONS:Laparoscopicexplantationofinfectedmeshesafterlaparoscopicherniarepairleadstolessscarringandearlyrecovery.Contaminationofanteriorabdominalwallaftercutaneousdrainageofdeep-seatedabscessisavoided.
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