Korenkov M, Sauerland S, Arndt M, Bograd L, Neugebauer E A M, Troidl H
Surgical Clinic and Biochemical and Experimental Division, Second Department of Surgery, University of Cologne, Cologne, Germany.
Br J Surg. 2002 Jan;89(1):50-6. doi: 10.1046/j.0007-1323.2001.01974.x.
Since conventional suture repair for incisional hernia is associated with high recurrence rates, alloplastic and autoplastic prosthetic techniques have been suggested.
In a randomized trial, 160 patients with simple or complex hernias underwent either suture repair, autodermal skin graft or onlay polypropylene mesh repair. Suture repair was not done in complex hernias. This report concerns a planned interim analysis.
At mean follow-up of 16 months, there were 17 hernia recurrences that were distributed similarly between the surgical techniques. There were fewer infectious complications after suture repair (three of 33 patients) than after skin graft or mesh repair (seven of 39 and five of 28 for simple hernias; seven of 31 and ten of 29 respectively for complex hernias) (P not significant). The severity of infections after polypropylene mesh implantation prompted the trial committee to discontinue the study. No differences were noted in duration of stay in hospital and quality of life. However, pain was significantly more frequent after polypropylene mesh repair (pooled risk ratio 2.9 and 1.8 at 6 weeks and 1 year respectively).
Suture repair was safe for small incisional hernias. Both autoplastic and alloplastic hernia repair yielded comparably low recurrence rates, but led to a high rate of wound infection.
由于传统的切口疝缝合修补术复发率较高，因此有人提出了使用异体和自体修复材料的修补技术。
在一项随机试验中，160例患有单纯性或复杂性疝的患者接受了缝合修补术、自体皮肤移植术或聚丙烯补片修补术。复杂性疝未采用缝合修补术。本报告涉及一项计划中的中期分析。
平均随访16个月时，共有17例疝复发，各手术技术组的复发情况相似。缝合修补术后的感染并发症（33例患者中有3例）少于皮肤移植或补片修补术后（单纯性疝分别为39例中的7例和28例中的5例；复杂性疝分别为31例中的7例和29例中的10例）（P值无统计学意义）。聚丙烯补片植入术后感染的严重程度促使试验委员会终止了该研究。住院时间和生活质量方面未发现差异。然而，聚丙烯补片修补术后疼痛明显更频繁（6周和1年时的合并风险比分别为2.9和1.8）。
缝合修补术对小切口疝是安全的。自体和异体疝修补术的复发率相当低，但伤口感染率较高。
