Аннотация

Цель
To assess the incidence and risk factors associated with trocar entry site hernias (TESH) following laparoscopic cholecystectomy (LC).
Материал и методы
A retrospective study was conducted based on the medical records of 400 patients who underwent LC using the American technique between 2017 and 2020. Diagno-sis of TESH was confirmed through abdominal examination, palpation, and abdominal ultrasound. The minimum follow-up period was 5 years.
Результаты
The mean age of patients was 51.9 ± 14.5 years, with a female-to-male ratio of 2.2:1. The overall incidence of TESH was 21.7% (87/400), with the majority of hernias developing in the umbilical region after the use of trocars larger than 10 mm in diameter. Additional risk factors identified included obesity, enlargement of the umbilical defect, and the presence of large gall-stones. Inadequate or absent fascial closure was also found to contribute to the development of TESH.
Заключение
The incidence of trocar site hernias after LC may be significantly higher than commonly reported, especially with long-term follow-up. The use of large diameter trocars in the umbilical region requires special attention, and TESH prevention strategies should include individu-alized assessment of abdominal wall anatomy, meticulous fascial closure techniques, and immediate hernia repair when a pre-existing defect is identified.

Ключевые слова

trocar site hernia laparoscopic cholecystectomy

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