Akın ÖNDER, Metehan GÜMÜŞ, Abdullah BÖYÜK, Sadullah GİRGİN, Murat KAPAN

Laparoskopik Kolesistektomi Sonrası Trokar Giriş Yeri Hernileri

Giriş ve Amaç: Laparoskopik kolesistektomiden (LK) sonra trokar yerinde insizyonel herni(TH) gelişimi nadir bir komplikasyondur. Çalışmamızda LK’ler sonrası gelişen TH’lerin güncelliteratür eşliğinde sunulması amaçlanmıştır.Materyal Metot: Ocak 2007-Haziran 2010 tarihleri arasında LK uygulanan 515 hastadan THgelişenlerin kayıtları yaş, cinsiyet, fıtığın gelişim yeri ve büyüklüğü, yapılan operasyon ile riskfaktörleri açısından retrospektif olarak incelendi.Bulgular: LK uygulanan hastalardan 3(%0.58)’ünde TH saptandı. Ortalama yaş; 49.67±5.77idi ve hepsi kadındı. İki hastada umblikal, 1 hastada epigastrik bölgede 10 mm’lik trokar girişyerlerinde TH saptandı. LK’den TH gelişimine kadar geçen ortalama süre 18.33±10.97 aydı.Herni defekti çapı 1.33±0.29 cm’di. Vücut/kitle indeksi ortalama 30.3±3.1’di. Bir hastada, LKesnasında 2 cm çapında taş saptanırken, diğerlerinde 1 cm’den küçük multipl taş saptandı. Birhastada umblikal bölgede LK sonrası enfeksiyon gelişti.Sonuç: LK sonrası TH gelişimi nadir olsa da, özellikle risk faktörü taşıyanlarda 10 mm ve dahabüyük çaplı trokar yerleri sütüre edilmelidir

Anahtar Kelimeler:

Trokar, herni, laparoskopi, kolesistektomi

Trocar-Site Hernias After Laparoscopic Cholecystectomy

Introduction: Trocar-site hernia (TH) development after laparoscopic cholecystectomy (LC)is a rare complication. In this study, we aimed to investigate the TH after LC in the light ofcurrent literature.Methods: Between January 2007 and June 2010, the records of the patients with TH in 515patients performed LC analyzed retrospectively in terms of age, sex, location, size, performedprevious operation and risk factors.Results: TH was determined in 3 (0.58%) patients among patients underwent LC. The averageage was 49.67±5.77 and all of them were women. The 10-mm trocars entry site related to THappeared at umbilical region for 2 patients and at epigastric region for patient. The average timefrom LC to TH formation was 18.33±10.97 months. The diameter of the hernia defects were1.33±0.29 cm. The average of body mass index was 30.3 ± 3.1. During the LC, 2 cm in diametergallstone in 1 patient and multiple gallstones smaller than 1 cm in the others were detected.Wound infection at the umbilical trocar region in one patient was detected after LC.Conclusion: Although the risk of TH after LC is rare, 10 mm or larger diameter trocar sitesshould be sutured especially in the patients including risk factors

Keywords:

Trocar, hernia, laparoscopy, cholecystectomy,

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