Petersen S, Henke G, Freitag M, Hellmich G, Ludwig K
Klinik für Allgemein- und Abdominalchirurgie, Krankenhaus Dresden-Friedrichstadt.
Zentralbl Chir. 2000;125(2):152-6.
The observed recurrence-rate up to 20-50% of conventional incisional-hernia repair might be improved by alloplastic hernia repair in "sublay-technique" described by Stoppa and Rives.
From 12/94 to 12/97 122 pt. underwent surgery of incisional hernia of whom 50 had a very large abdominal wall defect so that hernia repair by alloplastic technique was necessary. All 50 pt. had mesh-implantation in subfascial plane, 28 pt. by ePTFE-patch (Gore-Tex) and 22 pt. by polypropylen-mesh (Prolene).
The implantation-procedure required a mean time of 165 min. (range 55-345 min.). There were pulmonary complications in 2 patients (4%) of whom one had to be ventilated over 34 days, prosthesis-infection occurred in 3 pt. (6%). Follow-up on average 19 months (range 5-44 months) postoperatively revealed 5 hernia-recurrences (10.4%) in 48 patients.
Mesh-implantation for hernia repair in sublay-technique requires intensive preparation of preperitoneal plane. Thus it took approximately 3 hours for mesh-implantation in this study. From our data Stoppa-Rives-procedure seems to be effective for 4-repair of large incisional hernias and allows immediate abdominal wall stress.
采用Stoppa和Rives描述的“腹膜前修补技术”进行的人工合成材料疝修补术，可能会改善传统切口疝修补术高达20%-50%的复发率。
从1994年12月至1997年12月，122例患者接受了切口疝手术，其中50例患者腹壁缺损非常大，因此需要采用人工合成材料技术进行疝修补。所有50例患者均在筋膜下平面植入补片，28例患者使用ePTFE补片（Gore-Tex），22例患者使用聚丙烯补片（Prolene）。
植入手术平均需要165分钟（范围为55-345分钟）。2例患者（4%）出现肺部并发症，其中1例需要机械通气34天，3例患者（6%）发生假体感染。术后平均随访19个月（范围为5-44个月），48例患者中有5例（10.4%）疝复发。
采用腹膜前修补技术植入补片进行疝修补需要对腹膜前平面进行充分准备。因此，本研究中补片植入耗时约3小时。根据我们的数据，Stoppa-Rives手术似乎对大型切口疝的修补有效，并且可以立即承受腹壁压力。
