A comparative study of intraperitoneal repair and preperitoneal repair in the treatment of incisional hernia

doi:10.3877/cma.j.issn.1674-392X.2021.06.017

Abstract

Abstract:

Objective

To investigate the effect and complications of preperitoneal space and intraperitoneal mesh placement in the treatment of incisional hernia.

Methods

The clinical data of 65 patients with incisional hernia treated by the Department of General surgery of the sixth affiliated Hospital of Xinjiang Medical University from October 2017 to October 2019 were retrospectively analyzed. The patients were divided into intraperitoneal onlay mesh (IPOM) technique group and Sublay group according to the treatment method. Among them, 31 cases in IPOM group were treated with intraperitoneal repair, and 34 cases in Sublay group were treated with preperitoneal repair. The operation-related indexes, complications, postoperative pain and recurrence of the two groups were observed.

Results

The intraoperative bleeding (29.0±6.5) ml, postoperative hospital stay (6.1±1.8) days and 72 hours visual analogue score (VAS) (1.94±0.77) points of IPOM group were lower than those of sublay group (35.3±7.4) ml, (8.9±2.1) days, (2.91±0.83) points. The total cost of hospitalization in IPOM group (29 119.6±2490.7) yuan was higher than that in Sublay group (24 062.0±3315.9) yuan. The differences were statistically significant (P<0.05). The total incidence of complications in IPOM group (3 cases, 9.68%) was lower than that in Sublay group (6 cases, 17.65%). During the follow-up, there were 0 cases of recurrence in the IPOM group and 2 cases (5.88%) in the Sublay group. There was no significant difference (P>0.05).

Conclusion

Both preperitoneal repair and intraperitoneal repair are safe and effective. Appropriate and effective treatment methods should be selected according to the individual situation of patients.

Key words: Incisional hernia, Herniorrhaphy, Complication

Guolin Zhang, Abudureyimu Paerhati·. A comparative study of intraperitoneal repair and preperitoneal repair in the treatment of incisional hernia[J]. Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition), 2021, 15(06): 613-616.

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References 22

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组别	例数	男性/女性(例)	年龄(岁)	体质量指数(kg/m²)	腹壁缺损大小(cm)
IPOM组	31	14/17	60.5±7.39	24.0±1.90	9.7±1.8
Sublay组	34	15/19	62.3±7.80	23.7±1.88	9.9±2.0
χ²/t值		0.007	0.926	0.764	0.560
P值		0.933	0.358	0.448	0.577

组别	例数	男性/女性(例)	年龄(岁)	体质量指数(kg/m²)	腹壁缺损大小(cm)
IPOM组	31	14/17	60.5±7.39	24.0±1.90	9.7±1.8
Sublay组	34	15/19	62.3±7.80	23.7±1.88	9.9±2.0
χ²/t值		0.007	0.926	0.764	0.560
P值		0.933	0.358	0.448	0.577

组别	例数	手术时间(min)	术后住院时间(d)	术中出血(ml)	住院总费用(元)
IPOM组	31	106.6±21.3	6.1±1.8	29.0±6.5	29 119.6±2490.7
Sublay组	34	111.0±19.9	8.9±2.1	35.3±7.4	24 062.0±3315.9
t值		0.863	5.268	3.613	6.899
P值		>0.05	<0.05	<0.05	<0.05

组别	例数	手术时间(min)	术后住院时间(d)	术中出血(ml)	住院总费用(元)
IPOM组	31	106.6±21.3	6.1±1.8	29.0±6.5	29 119.6±2490.7
Sublay组	34	111.0±19.9	8.9±2.1	35.3±7.4	24 062.0±3315.9
t值		0.863	5.268	3.613	6.899
P值		>0.05	<0.05	<0.05	<0.05

组别	例数	肠管损伤	肠梗阻	血清肿	切口感染	并发症总数
IPOM组	31	1(3.23)	2(6.45)	0	0	3(9.68)
Sublay组	34	0	1(2.94)	2(5.88)	3(8.82)	6(17.65)^a

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