Trocar-site hernia after gynecological laparoscopic surgery: a 20-year, single-center experience

作     者：Ya-Pei Zhu Shuo Liang Lan Zhu Zhi-Jing Sun Jing-He Lang Zhu Ya-Pei;Liang Shuo;Zhu Lan;Sun Zhi-Jing;Lang Jing-He

作者机构：Department of Obstetrics and GynecologyPeking Union Medical College HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100730China 

出 版 物：《Chinese Medical Journal》 (中华医学杂志（英文版）)

年 卷 期：2019年第132卷第22期

页      面：2677-2683页

核心收录：

学科分类：1002[医学-临床医学] 100210[医学-外科学(含：普外、骨外、泌尿外、胸心外、神外、整形、烧伤、野战外)] 10[医学] 

基　　金：supported by a grant from the Chinese Academy of Medical Sciences Initiative for Innovative Medicine 

主　　题：Prevention Risk-factors Single-incision laparoscopic surgery Trocar-site hernia 

摘      要：Background:Trocar-site hernia(TSH)is a serious complication after laparoscopic *** it is a rare entity,it have life-threatening *** study aimed to retrospectively analyze the potential associated factors for TSH following gynecologic laparoscopy and summarize prevention strategies based on our ***:We searched for gynecological laparoscopic surgeries in the medical records system of Peking Union Medical College Hospital(PUMCH)from August 1998 to July 2018 and further sifted through the results for cases involving *** included patients were divided into different groups according to patient characteristics,and the rate of TSH was compared among ***,the detailed information of all patients with TSH was recorded and *** analyses were performed with GraphPad Prism ***:The approximate total rate of post-operative TSH among gynecologic laparoscopy procedures performed at PUMCH in the last 20 years was 0.016%(9/55,244).The rate of TSH was significant higher in elder patients(60 years old;3/2686,0.112%)than in younger patients(60 years old,6/52,558;0.011%,P=0.008).Moreover,the approximate rate of TSH was significantly higher after single-incision laparoscopic surgery(SILS,2/534,0.357%)than conventional laparoscopic surgery(7/54,710,0.013%,P=0.003).The average age of patients with TSH was 53.4 years(range,35.0-79.0 years).Two of the nine patients had late-onset TSH following SILS;the other seven had early-onset TSH following conventional *** TSH cases occurred at right lateral port sites,and the remaining three occurred at the umbilical port *** patients underwent repair surgery,and one required small bowel ***:Older age and SILS are potential associated factors for TSH development,while reducing excessive manipulation and improving suturing skills,especially at the umbilical trocar site following SILS and the right lateral trocar site,can avoid herniation.