引用文本：李英儒, 刘付恒, 范国勇, 等. 立体缝合技术在腹腔镜下腹腔内补片修补术中的应用：一项多中心回顾性研究[J/CD]. 消化肿瘤杂志（电子版）, 2026, 18(1): 145-151.

作者：李英儒¹，刘付恒¹，范国勇²，李颖³，元志龙¹，甘文昌¹，彭绍勇¹，周太成¹，陈双¹，曾兵¹

单位：1. 中山大学附属第六医院疝与腹壁外科，广东 广州 510655；2. 佛山市第一人民医院疝和腹壁外科，广东 佛山528000；3. 汕头市中心医院普外二科，广东 汕头 515100

Authors：Li Yingru¹, Liu Fuheng¹, Fan Guoyong², Li Ying³, Yuan Zhilong¹, Gan Wenchang¹, Peng Shaoyon1¹, Zhou Taicheng¹, Chen Shuang¹, Zeng Bing¹

Unit：1. Department of Hernia and Abdominal Wall Surgery, the Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou 510655, Guangdong, China；2. Department of Hernia and Abdominal Wall Surgery, Foshan First People's Hospital, Foshan 528000, Guangdong, China；3. Department of General Surgery Ⅱ, Shantou Central Hospital, Shantou 515100, Guangdong, China

摘要：

目的 评估立体缝合技术在腹腔镜下腹腔内补片修补术（intraperitoneal onlay mesh, IPOM）中关闭腹壁缺损的应用价值。方法 采用多中心回顾性队列研究的方法，纳入分析2018年1月至2022年1月中山大学附属第六医院、佛山市第一人民医院和汕头市中心医院3家医疗中心共204例接受IPOM且采用立体缝合关闭缺损的切口疝患者。主要观察终点为术后3个月内手术部位事件（surgical site occurrence, SSO）、术后慢性疼痛发生率，以及术后3年复发率。次要终点包括手术时间、术中出血量、30 d再住院率、30 d再手术率等。术后随访按标准化流程执行，时间节点包括术后1周、1个月、3个月、1年和3年。结果  204例切口疝患者中男性95例，女性109例；平均年龄（63.1±12.3）岁；体重指数24.5（22.3, 27.2） kg/m²；中线疝146例，侧腹壁疝58例；缺损最大径（10.6±5.2） cm；复发疝患者33例（16.2%）。手术时间（166.8±58.4） min，其中立体缝合时间（71.5±14.3） min，术中出血量为20.0（10.0, 30.0） ml，术后住院6.0（5.0, 7.0） d；30 d再住院率4.4%，无再手术及死亡病例。术后并发症中，SSO发生率3.9%，慢性疼痛发生率11.8%，术后3年复发率为4.4%。结论  立体缝合技术在IPOM中安全可行，为切口疝腹壁缺损关闭提供了新的思路和临床证据。

关键词：切口疝；腹腔内补片修补术；腹腔镜；立体缝合；筋膜缝合

Abstract：

Objective To evaluate the application value of the multidimensional suture technique for closing abdominal wall defects during laparoscopic intraperitoneal onlay mesh (IPOM) repair. Method A multicenter retrospective cohort design was employed. A total of 204 patients with incisional hernias who underwent IPOM with defect closure using the multidimensional suture technique between January 2018 and January 2022 from the Sixth Affiliated Hospital of Sun Yat-sen University, Foshan First People's Hospital and Shantou Central Hospital were included for analysis. Primary endpoints included surgical site occurrences (SSO) within 3 months postoperatively and the incidence of chronic pain postoperatively, as well as recurrence rate at 3 years postoperatively. Secondary endpoints included operative time, intraoperative blood loss, 30-day readmission rate, and 30-day reoperation rate, etc. Postoperative follow-up was conducted according to a standardized protocol at 1 week, 1 month, 3 months, 1 year and 3 years. Result Among the 204 incisional hernia patients, there were 95 males and 109 females; the mean age was (63.1±12.3) years; the median body mass index was 24.5 (22.3, 27.2) kg/m²; 146 cases were midline hernias and 58 were lateral abdominal wall hernias; the longest defect diameter was (10.6±5.2) cm; 33 patients (16.2%) had recurrent hernias. Intraoperative indicators showed an operative time of (166.8±58.4) minutes, with the multidimensional suture procedure taking (71.5±14.3) minutes, median intraoperative blood loss was 20.0 (10.0, 30.0) ml, and the median postoperative hospital stay was 6.0 (5.0, 7.0) days. The 30-day readmission rate was 4.4%, with no cases of reoperation or mortality. Postoperative complications included an SSO rate of 3.9%, chronic pain rate of 11.8%, and a 3-year recurrence rate of 4.4%. Conclusion The multidimensional suture technique demonstrated favorable postoperative complication and recurrence rates in IPOM repair, exhibiting safety and clinical feasibility. It provides an innovative solution for closing abdominal wall defects in incisional hernia repair.

Key words：Incisional hernia; Intraperitoneal onlay mesh; Laparoscopy; Multidimensional suture; Fascial closure

注：网络优先发布