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切口疝的手术修复:使用人工材料(膨体聚四氟乙烯戈尔特斯双网片)的无张力技术

Surgical repair of incisional ventral hernias: tension-free technique using prosthetic materials (expanded polytetrafluoroethylene Gore-Tex Dual Mesh).

作者信息

Chrysos E, Athanasakis E, Saridaki Z, Kafetzakis A, Dimitriadou D, Koutsoumpas V, Chalkiadakis G, Xynos E, Zoras O

机构信息

Department of General Surgery, University Hospital of Heraklion, Medical School, University of Crete, Greece.

出版信息

Am Surg. 2000 Jul;66(7):679-82.

Abstract

Repairing an incisional ventral hernia is a major challenge for a surgeon. The high recurrence rates observed during hernia repair by tissue approximation led to development of tension-free procedures by using prosthetic materials. The purpose of this study is to report the results of a tension-free repair technique using expanded polytetrafluoroethylene Gore-Tex Dual Mesh (Gore-Tex Soft Tissue Patch, W.L. Gore and Associates Inc, Flagstaff, AZ) in patients with primary or recurrent incisional ventral hernias. Over 3 years, 52 patients with incisional hernias have undergone this procedure in our clinic. Fourteen of them had recurrent hernias which had been primarily repaired by Mayo hernioplasty. Six of our patients had irreducible hernias preoperatively. Twenty-five patients had hernias on midline incisions, and the rest of them had hernias on transverse abdominal incisions. The median patient age was 65 years, and all were operated on under general anesthesia. The majority of the patients had 4 to 6 days of hospitalization. A subcutaneous seroma developed in eight patients. They all were treated by multiple paracentesis. Four of our patients experienced wound infection and were treated by mesh removal. None of the patients presented with cardiovascular or pulmonary complications. During the follow-up period, no other hernia recurrence, except the cases with mesh removal, has been noticed. The tension-free incisional hernia repair using expanded polytetrafluoroethylene mesh is, to our experience, a safe and easy procedure with no major morbidity or recurrence.

摘要

修复腹壁切口疝对外科医生来说是一项重大挑战。在通过组织对合进行疝修补术时观察到的高复发率促使人们开发了使用人工材料的无张力手术方法。本研究的目的是报告使用膨体聚四氟乙烯戈尔泰克斯双层补片(戈尔泰克斯软组织补片,W.L.戈尔联合公司,弗拉格斯塔夫,亚利桑那州)对原发性或复发性腹壁切口疝患者进行无张力修补技术的结果。在3年多的时间里,我们诊所对52例腹壁切口疝患者进行了该手术。其中14例为复发性疝,最初采用梅奥疝修补术进行修补。我们的6例患者术前存在难复性疝。25例患者的疝位于中线切口,其余患者的疝位于腹部横切口。患者的中位年龄为65岁,均在全身麻醉下接受手术。大多数患者住院4至6天。8例患者出现皮下血清肿,均通过多次穿刺抽吸进行治疗。我们的4例患者发生伤口感染,通过取出补片进行治疗。没有患者出现心血管或肺部并发症。在随访期间,除了取出补片的病例外,未发现其他疝复发。根据我们的经验,使用膨体聚四氟乙烯补片进行无张力腹壁切口疝修补术是一种安全、简便的手术,没有严重的并发症或复发。

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