The risk factors of bulging after hernia repair of ventral hernia

doi:10.3877/cma.j.issn.1674-392X.2019.05.004

Abstract

Abstract:

Objective

To investigate the incidence and risk factors of bulging after herniorrhaphy for ventral hernia.

Methods

To analysis of the relationship between incidence and clinical case factors of 774 patients who underwent herniorrhaphy for ventral hernia from January 2008 to December 2017.

Results

After 3 to 18 months of follow-up, the postoperative hospital stay was (8.15±2.60) days, bulging was found in 58 cases (7.49%) of 774 patients postoperatively, which was correlated with body mass index (BMI), emergency cases, mesh position, surgical approach and defect closure.

Conclusion

The BMI, emergency cases, mesh position, surgical approach and defect closure were independent risk factors of bulging after herniorrhaphy for ventral hernia. In order to prevent and reduce the occurrence of bulging, we should strengthen the screening of preoperative cases, reduce the emergency operation rate, strictly control the weight of patients, select appropriate surgical methods and materials, close the defect facial and strengthen the management of incision after operation.

Key words: Hernia, ventral, Herniorrhaphy, Bulging, Hernia recurrence, Complications

Shaojie Li, Jianxiong Tang, Lei Huang, Zhao Cai, Xingchen Hu, Yunxiao Meng, Shaochun Li. The risk factors of bulging after hernia repair of ventral hernia[J]. Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition), 2019, 13(05): 398-403.

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URL: https://zhshfbwkzz.cma-cmc.com.cn/EN/10.3877/cma.j.issn.1674-392X.2019.05.004

https://zhshfbwkzz.cma-cmc.com.cn/EN/Y2019/V13/I05/398

Figures/Tables 4

References 12

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基本信息		例数	疝复发[例(%)]	P值	腹壁膨出[例(%)]	P值
依据性别分类		?	?	0.127	?	0.332
?	男性	262	9(3.44)	?	17(6.49)	?
?	女性	512	20(3.91)	?	34(6.64)	?
依据腹壁缺损大小分类^#		?	?	<0.001	?	0.137
?	小切口疝(<4 cm)	96	2(2.08)	?	7(7.29)	?
?	中切口疝(4~8 cm)	347	8(2.31)	?	24(6.92)	?
?	大切口疝(8~12 cm)	290	11(3.79)	?	18(6.21)	?
?	巨大切口疝(>12 cm)	41	8(19.51)	?	9(21.95)	?
依据腹壁缺损部位分类^#		?	?	0.606	?	0.098
?	前腹壁中央区域	407	14(3.44)	?	27(6.63)	?
?	前腹壁边缘区域切口疝	324	13(4.01)	?	24(7.41)	?
?	侧腹壁和背部切口疝	43	2(4.65)	?	7(16.28)	?
依据是否为疝复发分类^#		?	?	0.308	?	0.242
?	初发切口疝	546	18(3.30)	?	37(6.78)	?
?	复发切口疝	228	11(4.82)	?	21(9.21)	?
依据BMI分类		?	?	0.017	?	0.032
?	BMI≤25g/m²	123	2(1.63)	?	1(0.81)	?
?	25 g/m²<BMI≤30 g/m²	582	16(2.75)	?	41(7.04)	?
?	BMI>30 g/m²(%)	69	11(15.94)	?	9(13.04)	?
依据是否急诊手术分类		?	?	<0.001	?	<0.001
?	急诊手术(%)	58	8(13.79)	?	19(32.76)	?
?	非急诊手术(%)	716	21(2.93)	?	32(4.47)	?

基本信息		例数	疝复发[例(%)]	P值	腹壁膨出[例(%)]	P值
依据性别分类		?	?	0.127	?	0.332
?	男性	262	9(3.44)	?	17(6.49)	?
?	女性	512	20(3.91)	?	34(6.64)	?
依据腹壁缺损大小分类^#		?	?	<0.001	?	0.137
?	小切口疝(<4 cm)	96	2(2.08)	?	7(7.29)	?
?	中切口疝(4~8 cm)	347	8(2.31)	?	24(6.92)	?
?	大切口疝(8~12 cm)	290	11(3.79)	?	18(6.21)	?
?	巨大切口疝(>12 cm)	41	8(19.51)	?	9(21.95)	?
依据腹壁缺损部位分类^#		?	?	0.606	?	0.098
?	前腹壁中央区域	407	14(3.44)	?	27(6.63)	?
?	前腹壁边缘区域切口疝	324	13(4.01)	?	24(7.41)	?
?	侧腹壁和背部切口疝	43	2(4.65)	?	7(16.28)	?
依据是否为疝复发分类^#		?	?	0.308	?	0.242
?	初发切口疝	546	18(3.30)	?	37(6.78)	?
?	复发切口疝	228	11(4.82)	?	21(9.21)	?
依据BMI分类		?	?	0.017	?	0.032
?	BMI≤25g/m²	123	2(1.63)	?	1(0.81)	?
?	25 g/m²<BMI≤30 g/m²	582	16(2.75)	?	41(7.04)	?
?	BMI>30 g/m²(%)	69	11(15.94)	?	9(13.04)	?
依据是否急诊手术分类		?	?	<0.001	?	<0.001
?	急诊手术(%)	58	8(13.79)	?	19(32.76)	?
?	非急诊手术(%)	716	21(2.93)	?	32(4.47)	?

手术方法		例数	疝复发[例(%)]	P值	腹壁膨出[例(%)]	P值
依据手术入路分类		?	?	0.889	?	0.033
?	开放手术	691	25(3.62)	?	45(6.51)	?
?	腹腔镜手术	46	3(6.52)	?	11(23.91)	?
?	杂交手术	37	1(2.70)	?	2(5.41)	?
依据补片放置层次分类		?	?	<0.001	?	<0.001
?	IPOM	321	9(2.80)	?	22(6.85)	?
?	Sublay	364	9(2.47)	?	16(4.40)	?
?	Onlay	39	1(2.56)	?	1(2.56)	?
?	Inlay	18	4(22.22)	?	7(38.89)	?
?	单纯缝合修补术	32	6(18.75)	?	12(37.5)	?
依据使用补片的种类分类		?	?	<0.001	?	<0.001
?	合成材料	705	20(2.84)	?	33(4.68)	?
?	生物材料	37	3(8.11)	?	13(35.14)	?
?	单纯缝合修补术	32	6(18.75)	?	12(37.5)	?

手术方法		例数	疝复发[例(%)]	P值	腹壁膨出[例(%)]	P值
依据手术入路分类		?	?	0.889	?	0.033
?	开放手术	691	25(3.62)	?	45(6.51)	?
?	腹腔镜手术	46	3(6.52)	?	11(23.91)	?
?	杂交手术	37	1(2.70)	?	2(5.41)	?
依据补片放置层次分类		?	?	<0.001	?	<0.001
?	IPOM	321	9(2.80)	?	22(6.85)	?
?	Sublay	364	9(2.47)	?	16(4.40)	?
?	Onlay	39	1(2.56)	?	1(2.56)	?
?	Inlay	18	4(22.22)	?	7(38.89)	?
?	单纯缝合修补术	32	6(18.75)	?	12(37.5)	?
依据使用补片的种类分类		?	?	<0.001	?	<0.001
?	合成材料	705	20(2.84)	?	33(4.68)	?
?	生物材料	37	3(8.11)	?	13(35.14)	?
?	单纯缝合修补术	32	6(18.75)	?	12(37.5)	?

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