Comparative study of onlay repair and preperitoneal hernia repair in umbilical hernia complicated with cirrhosis ascites

doi:10.3877/cma.j.issn.1674-392X.2019.03.020

Abstract

Abstract:

Objective

To investigate the difference between onlay and sublay repair in surgical treatment of umbilical hernia complicated with cirrhotic ascites.

Methods

The data of patients with umbilical hernia complicated with hepatocirrhosis ascites in Beijing Chao-Yang Hospital from January 2010 to January 2018 were retrospectively analyzed. 25 cases were selected according to the criteria of inclusion and exclusion. According to onlay and sublay operation, they were divided into two groups: control group and experimental group. The preoperative ascites depth, operation time, exhaust time, hospital stay, postoperative wound healing and recurrence were observed and compared statistically.

Results

In the control group, the average length of operation was (56.9±16.3) minutes, the hospitalization time was (8.7±5.8) days, and the exhaust time was (2.6±0.7) days. In the experimental group, the average length of operation was (49.4±17.1) minutes, the hospitalization time was (10.8±4.7) days, and the exhaust time was (2.7±0.6) days. There was no significant difference in postoperative pain score and wound healing between the two groups, and only 1 case in the control group had mild wound infection, and all the patients had no recurrence, and good therapeutic effect was obtained during the observation period.

Conclusion

Both onlay and sublay repair are safe and effective for patients with umbilical hernia complicated with cirrhosis ascites.

Key words: Umbilical hernia, Cirrhosis ascites, Surgical treatment

Chuanwen Miao, Dejian Chen. Comparative study of onlay repair and preperitoneal hernia repair in umbilical hernia complicated with cirrhosis ascites[J]. Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition), 2019, 13(03): 267-269.

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References 15

[1]	刘彤，陈志雨. 成人脐疝无张力修补18例分析[J]. 中国实用外科杂志, 2006, 26(4): 297.
[2]	Chatzizacharias NA, Bradley JA, Harper S, et al. Successful surgical management of ruptured umbilical hernias in cirrhotic patients[J]. World J Gastroenterol, 2015, 21(10): 3109-3113.
[3]	Hassan AM, Salama AF, Hamdy H, et al. Outcome of sublay mesh repair in non-complicated umbilical hernia with liver cirrhosis and ascites[J]. Int J Surg, 2014, 12(2): 181-185.
[4]	赵渝. 腹壁疝修补术后并发症原因及防治[J]. 中国实用外科杂志, 2008, 28(12): 1070-1071.
[5]	刘畅，尹涛. 局部麻醉下无张力疝修补术在肝硬化腹水并发腹壁疝患者中的应用[J/CD]. 中华疝和腹壁外科杂志(电子版), 2014, 8(4): 342-343.
[6]	Triantos CK, Nikolopoulou V, Kehagias I, et al. Surgical Repair of Umbilical Hernias in Cirrhosis With Ascites[J]. Am J Med Sci, 2011, 341(3): 222-226.
[7]	Marsman HA, Heisterkamp J, Halm JA, et al. Management in patients with liver cirrhosis and an umbilical hernia[J]. Surgery(St Louis), 2007, 142(3): 372-375.
[8]	Eker HH, Ramshorst GHV, Goede BD, et al. A prospective study on elective umbilical hernia repair in patients with liver cirrhosis and ascites[J]. Surgery, 2011, 150(3): 542-546.
[9]	刘素君，陈杰，申英末. 脐疝合并腹水的疝修补手术治疗[J]. 中华普通外科杂志, 2009, 24(11): 878-881.
[10]	庄心良，曾因明，陈伯銮. 现代麻醉学(上册)[M]. 北京: 人民卫生出版社, 2003: 792-793.
[11]	中华医学会肝病学分会. 慢性乙型肝炎防治指南(2010年版)[J]. 中华内科杂志, 2011, 3(2): 66-82.
[12]	严红霞. 肝硬化腹水并发脐疝择期手术围手术期护理[J]. 医药前沿, 2016, 6(13): 314-315.
[13]	王然，祁兴顺，郭晓钟. 肝硬化患者脐疝与腹水量的关系[J]. 临床肝胆病杂志, 2017, 35(2): 323.
[14]	Runyon BA. Management of adult patients with ascites due to cirrhosis[J]. Hepatology, 2004, 39(3): 841-856.
[15]	孙力波，张海涛，赵晓飞, 等. 脐疝合并肝硬化腹水患者修补术治疗体会[J/CD]. 中华疝和腹壁外科杂志(电子版), 2017, 11(4): 244-246.

组别	例数	性别组成(男/女)	平均年龄(岁)	BMI(kg/m²)	腹水深度(cm)	疝环直径(cm)	术前肝功能分级
组别	例数	性别组成(男/女)	平均年龄(岁)	BMI(kg/m²)	腹水深度(cm)	疝环直径(cm)	Child-Pugh B级	Child-Pugh C级
对照组	13	7/6	63.7±11.2	27.8±1.8	5.7±1.0	2.15±0.7	1	12
试验组	12	5/7	62.5±8.6	27.5±1.3	5.5±1.1	2.1±0.793	1	11
P值		0.543	0.978	0.765	0.683	0.731	0.953

组别	例数	性别组成(男/女)	平均年龄(岁)	BMI(kg/m²)	腹水深度(cm)	疝环直径(cm)	术前肝功能分级
组别	例数	性别组成(男/女)	平均年龄(岁)	BMI(kg/m²)	腹水深度(cm)	疝环直径(cm)	Child-Pugh B级	Child-Pugh C级
对照组	13	7/6	63.7±11.2	27.8±1.8	5.7±1.0	2.15±0.7	1	12
试验组	12	5/7	62.5±8.6	27.5±1.3	5.5±1.1	2.1±0.793	1	11
P值		0.543	0.978	0.765	0.683	0.731	0.953

组别	例数	住院时间(d)	手术时间(min)	排气时间(d)	VAS评分(分)
对照组	13	8.7±5.8	56.9±16.3	2.6±0.7	2.9±0.8
试验组	12	10.8±4.7	49.4±17.1	2.7±0.6	2.7±0.6
P值		>0.05	>0.05	>0.05	>0.05

组别	例数	住院时间(d)	手术时间(min)	排气时间(d)	VAS评分(分)
对照组	13	8.7±5.8	56.9±16.3	2.6±0.7	2.9±0.8
试验组	12	10.8±4.7	49.4±17.1	2.7±0.6	2.7±0.6
P值		>0.05	>0.05	>0.05	>0.05

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