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中华疝和腹壁外科杂志(电子版) ›› 2018, Vol. 12 ›› Issue (05) : 360 -362. doi: 10.3877/cma.j.issn.1674-392X.2018.05.011

所属专题: 文献

论著

肌后间隙修补法治疗腹壁切口疝患者的疗效
倪敏1, 申英末2,(), 刘静2, 聂玉胜2, 韦皓棠1, 王佳雷1   
  1. 1. 530031 南宁市第二人民医院胃肠外科
    2. 100043 首都医科大学附属北京朝阳医院疝和腹壁外科
  • 收稿日期:2018-04-28 出版日期:2018-10-18
  • 通信作者: 申英末

Study of retromuscular mesh repair in the treatment of incisional hernias

Min Ni1, Yingmo Shen2,(), Jing Liu2, Yusheng Nie2, Haotang Wei1, Jialei Wang1   

  1. 1. Department of Gastrointestinal Surgery, the Second Nanning People’s Hospital, Nanning 530031, China
    2. Department of Hernia and Abdominal Wall Surgery, Beijng Chao-Yang Hospital, Capital Medical University, Beijing 100043, China
  • Received:2018-04-28 Published:2018-10-18
  • Corresponding author: Yingmo Shen
  • About author:
    Corresponding author: Shen Yingmo, Email:
引用本文:

倪敏, 申英末, 刘静, 聂玉胜, 韦皓棠, 王佳雷. 肌后间隙修补法治疗腹壁切口疝患者的疗效[J]. 中华疝和腹壁外科杂志(电子版), 2018, 12(05): 360-362.

Min Ni, Yingmo Shen, Jing Liu, Yusheng Nie, Haotang Wei, Jialei Wang. Study of retromuscular mesh repair in the treatment of incisional hernias[J]. Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition), 2018, 12(05): 360-362.

目的

探讨肌后间隙修补法(Sublay)在腹壁切口疝患者治疗中的手术效果。

方法

回顾性分析2015年1月至2017年8月,首都医科大学附属北京朝阳医院疝和腹壁外科107例行Sublay手术的腹壁切口疝患者的临床资料,分析患者的一般资料、手术方法、并发症及术后转归情况,随访其有无切口疝复发及补片相关并发症发生情况。

结果

本组患者均顺利完成手术,平均手术时间(60.3±7.8)min,平均住院时间(17.6±5.3)d,所有患者术后恢复良好,2例患者出现脂肪液化,经换药后伤口愈合;1例患者出现皮下血肿,1例患者出现血清肿,经局部加压保守治疗后治愈,无伤口感染及局部异物感,无死亡患者。随访时间6~38个月,平均随访时间(22.7±10.8)个月,无切口疝复发,无死亡患者,无补片感染、慢性疼痛及局部异物感等补片相关并发症发生。

结论

肌后间隙修补手术(Sublay)治疗腹壁切口疝结果满意,手术疗效较好。

Objective

To study the clinical effect of retromuscular mesh repair for incisional hernias.

Methods

A retrospective study was conducted on 107 patients of incisional hernia who underwent Sublay operation in Beijing Chao-Yang Hospital during January 2015 and December 2017. Demographic data, surgical technique, postoperative complications and postoperative recovery were analyzed.

Results

All the operations successfully completed. The mean operation time was (60.3±7.8) minutes. The mean hospitalization was (17.6±5.3) days. 2 patients developed incision fat liquefaction and finally recovered by continuous dressing changes. 1 patient had wound hematoma and 1 patient had seroma, were treated conservatively. There was no recurrence during the mean follow-up time of (22.7±10.8) months (range 4 to 40 months). No mesh related complications such as mesh infection, chronic postoperative pain and foreign body sensation was detected.

Conclusion

Retromuscular mesh repair (Sublay) for incisional hernia is an effective and effective method.

[1]
Kingsnorth A, LeBlanc K. Hernias: inguinal and incisional[J]. Lancet, 2003, 362(9395):1561-1571.
[2]
Mudge M, Hughes LE. Incisional hernia: a 10 year prospective study of incidence and attitudes[J]. Br J Surg, 1985, 72(1):70-71.
[3]
Burger J, van’tRiet M, Jeekel J. Abdominal incisions: techniques and postoperative complications[J]. Scand J Surg, 2003, 91(4):315-321
[4]
Kurzer M, Kark A, Selouk S, et al. Open mesh repair of incisional hernia using a sublay technique: long-term follow up[J]. World J Surg, 2008, 32(1):31-36.
[5]
中华医学会外科学分会疝与腹壁外科学组. 腹壁切口疝诊断和治疗指南(2018年版)[J]. 中国普通外科杂志, 2018, 27(7):812-816.
[6]
Sauerland S, Schmedt CG, Lein S, et al. Primary incisional hernia repair with or without polypropylene mesh: a report on 384 patients with 5-year follow-up[J]. Langenbecks Arch Surg, 2005, 390(5):408-412.
[7]
Basoglu M, Yildirgan MI, Yilmaz I, et al. Late complications of incisional hernias following prosthetic mesh repair[J]. Acta Chir Belg, 2004, 104(4):425-428.
[8]
de Vries Reilingh TS, van Geldere D, Langenhorst B, et al. Repair of large midline incisional hernias with polypropylene mesh comparison of three operative techniques[J]. Hernia, 2004, 8(1):56-59.
[9]
Wéber G, Baracs J, Horváth OP, et al. Onlay mesh provides significantly better results than sublay reconstruction. Prospective randomized multicenter study of abdominal wall reconstruction with sutures only, or with surgical mesh-results of a five-year follow-up[J]. Magy Seb, 2010, 63(5):302-311.
[10]
Georgiev-Hristov T, Celdrán A. Comment to: A systematic review of the surgical treatment of large incisional hernia. Deerenberg EB, Timmermans L, Hogerzeil DP, Slieker JC, Eilers PH, Jeekel J, Lange JF. Hernia 2015; 19: 89-101[J]. Hernia, 2015, 19(6):1019-1020.
[11]
Novitsky YW, Elliot HL, Orenstein SB, et al. Transversus abdominis muscle release: a novel approach to posterior compo- nent separation during complex abdominal wall reconstruction[J]. Am J Surg, 2012, 204(5):709-716.
[12]
Gibreel W, Sarr MG, Rosen M, et al. Technical considera-tions in performing posterior component separation with trans-verse abdominis muscle release[J]. Hernia, 2016, 20(3):449-459.
[13]
Pauli EM, Rosen MJ. Open ventral hernia repair with compo- nent separation[J]. Surg Clin North Am, 2013, 93(5):1111-1133.
[14]
孙志涛,闫慧明,申素纲, 等. 肌后间隙无张力修补书治疗切口疝20例分析[J/CD]. 中华疝和腹壁外科杂志(电子版), 2013, 7(3):285-286.
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