10 KB193 KB10 KB200520132006Hari, PetraKuhar, ManuelaRecek, DejanVrbanec, Borislavletnik:11številka:254 stranistr. 65-68ISSN:1318-8941COBISSID:21317849URN:URN:NBN:SI:doc-FFH0SGFAslSlovensko zdravniško društvoEndoskopska revijaHernia, VentralHernija ventralnakilakirurško zdravljenjeLaparoscopyLaparoskopijalaparoskopska kirurgijaSurgeryTreatment OutcomeZdravljenje, izidLaparoskopska hernioplastika ventralnih kil| Laparoscopic hernioplasty of ventral hernias|Background. Laparoscopy has been increasingly considered the therapy of choicein the management of ventral hernia. The paper presents our results and experience with this modern minimally invasive approach to the treatment of ventra hernias. Patients and Methods. Twenty-nine patients, aged 40 - 82 years(mean 58.4 yrs) were enrolled in the study. The male to female ratio was 1:3. Umbilical hernia was diagnosed in 55% of the patients, hernia after lowermedian laparotomy in 25%, hernia after upper median laparotomy and appendectomy in 10%, and hernia after pararectal laparotomy in 5%. All patients were operated on under general anaesthesia. Results. The mean operative time was 70 minutes. A perforation in a female patient, who had a serosal lesion rnanaged by laparoscopic suture closure, was repaired via laparotomy. Seroma formation was observed in four male patients, one female patient developed a haematoma in the hernial sac, and orne had recurrence eighteen months after surgery. Conclusion. We believe that laparoscopic repairof ventral hernias is superior to open surgery: it affords better visualization of the abdominal wall, and is associated with faster recovery and lower recurrence rates. Laparoscopic management, however, is costly and should therefore be reserved for strictly selected casesIzhodišča. Laparoskopska oskrba ventralnih kil se v zadnjem času vse bolj uveljavlja kot metoda izbire. V članku prikazujemo naše izkušnje in rezultate pri tej sodobni minimalno invazivni metodi zdravljenja bolnikov z ventralnimi kilami. Bolniki in metode. V študijo smo zajeli 29 bolnikov, povprečna starostje bila 58,4 let, razpon od 40 do 82 let, razmerje bolnikov in bolnic je bilo 1:3. 55% bolnikov je bilo z umbilikalnimi kilami, 25% s kilami po spodnji mediani laparotomiji, 10% po zgornji mediani laparotomiji in apendektomiji in 5% po pararektalni laparotomiji. Vsi bolniki so bili operirani v splošni anesteziji. Rezultati. Povprečen čas operacij je bil 70 minut. Pri bolnici z vidno spremenjeno serozo, ki smo jo prešili laparoskopsko, je nastala perforacija, ki smo jo oskrbeli skozi laparotomijo. Pri 4 bolnikih se je pojavil serom, pri eni bolnici hematom v kilni vreči, prieni bolnici se je eno leto in pol po operaciji kila spet pojavila. Zaključek. Menimo, da je laparoskopska metoda oskrbe ventralnih kil boljša od klasične, manj je recidivov, boljša je preglednost trebušne stene, hitrejše jeokrevanje. Ker je metoda draga, je opravičena le iz strogo medicinskih razlogovTEXTznanstveno časopisjejournalsSlovenian National E-content AggregatorNational and University Library of SloveniaSlovensko zdravniško društvo, Združenje za endoskopsko kirurgijo