Laparoskopik kolesistektomi sonrasi port yeri fıtığı: retrospektif klinik deneyim

Öz

Amaç: Kolesistektomi planlanan hastalarda laparoskopik kolesistektomi altın standarttır. Laparoskopik kolesistektomi esnasında veya sonrasında laparoskopiye bağlı komplikasyonlar görülebilir. Bu çalısmada port yeri hernisi insidansı ve predispozan faktörlerinin incelenmesi amaçlanmaktadır. Gereç ve yöntem: Ocak 2016-Mart 2021 tarihleri arasında hastanemiz genel cerrahi kliniğinde yapılan laparoskopik kolesistektomi operasyonları retrospektif olarak incelendi. Pnömoperitoneum oluşturmak için hasson tekniği kullanıldı. Tüm kolesistektomiler 4 port tekniği ile yapıldı. Tüm hastalarda umbilical trokar fasyası kapatıldı. Demografik veriler retrospektif olarak değerlendirildi. Bulgular: Port yeri hernisi insidansı %0,5 olarak bulundu. 15 hastada umblikal herni saptandı. 11 hasta erkek 4 hasta kadın idi. Ortalama yaş 55,4 idi. Ortalama herni tespit süresi 14,3 ay idi. Ortalama BMI 30,11 olarak bulundu. 4 hastada kronik hastalık mevcut idi. 14 hasta opere edildi. 1 hasta acil strangülasyon gelişmesi üzerine acil opere edildi. 3 hastada nüks saptandı. Mortalite gözlenmedi. Sonuç: Obezite, yaş kadın cinsiyet önemli risk faktörleri olarak degerlendirilmektedir. Serimizde umblikal port yerine tüm olgularda fasiyal kapama yapılmakta ancak en çok port hernisi umblikus portundan kaynaklanmaktadır.

Anahtar Kelimeler

• port yeri hernisi
• fasiyal kapama
• risk faktörleri
• laparoskopik kolesistektomi

Port-site hernia after laparoscopic cholecystectomy: retrospective clinical experience

Abstract

Purpose: Laparoscopic cholecystectomy is the gold standard in patients scheduled for cholecystectomy. Complications related to laparoscopy may occur during or after laparoscopic cholecystectomy. This study is aimed to examine the incidence of port-site hernia and its predisposing factors. Materials and methods: Laparoscopic cholecystectomy operations performed in the general surgery clinic of our hospital between January 2016 and March 2021 were reviewed retrospectively. The pneumoperitoneum was created by entering the abdomen with a mini-incision from the umbilicus using the Hasson technique. All cholecystectomies were performed using the 4-port technique. The umbilical trocar fascia was closed in all patients. Demographic data were evaluated retrospectively. Result: The incidence of port-site hernia was determined as 0.5%. The umbilical hernia was detected in 15 patients: 11 male and four female. The mean age was 55.4 years. The mean hernia detection time was 14.3 months. The mean body mass index [BMI] was found to be 30.11. Four patients had a chronic disease. Fourteen of the patients underwent surgery. One of the patients was operated on a mini-incision urgently due to the development of strangulation. Recurrence was detected in three patients. No mortality was observed. Conclusion: Obesity, age, and female gender are considered important risk factors. In our series, fascial closure was performed instead of the umbilical port in all cases, but most of the port site hernias originate from the umbilicus port.

Keywords

• Port-site hernia
• fascial closure
• risk factor
• laparoscopic cholecystectomy

Kaynakça

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