Arroyo Sebastián A, Pérez F, Serrano P, Costa D, Oliver I, Ferrer R, Lacueva J, Calpena R
Abdominal Wall Surgery Unit, Department of Surgery, University Hospital of Elche, Alicante, Spain.
Hernia. 2002 Dec;6(4):175-7. doi: 10.1007/s10029-002-0076-y. Epub 2002 Oct 19.
Given the outstanding outcome that prosthetic repair has recently achieved in the repair of inguinal hernia, we wonder whether it should be implemented as the gold-standard technique for umbilical hernia repair. We report on 213 adult patients who underwent surgery for umbilical hernia at our Day Surgery Unit from June 1992 to January 1998. Criteria for exclusion included problematic social and family environment and ASA IV status. A polypropylene plug was placed in small umbilical defects, whereas large defects (> 3 cm in diameter) were repaired with a polypropylene mesh. The mean follow-up was 64 months. The mean age was 57.1 years, with females accounting for the majority (57.8%). Most patients (88.3%) were classified as ASA I-II. With regard to the hernia size, 143 patients (67.1%) presented with small defects (< 3 cm). The anaesthetic technique of choice was local plus sedation. Reported complications included seroma (5.6%), haematoma (2.3%), wound infection (1.4%), and intolerance to prosthesis (0.95%), the last causing recurrence. The overall recurrence rate at a mean follow-up of 64 months was 0.95%. Prosthetic umbilical hernia repair can safely be performed in adults, and the rate of recurrence in this study is low in comparison to primary tissue repair.
鉴于人工修复术最近在腹股沟疝修补方面取得了显著成果，我们不禁思考它是否应成为脐疝修补的金标准技术。我们报告了1992年6月至1998年1月期间在我们日间手术单元接受脐疝手术的213例成年患者。排除标准包括存在问题的社会和家庭环境以及美国麻醉医师协会（ASA）IV级状态。对于较小的脐部缺损，放置聚丙烯补片，而较大的缺损（直径>3 cm）则用聚丙烯网片修复。平均随访时间为64个月。平均年龄为57.1岁，女性占大多数（57.8%）。大多数患者（88.3%）被归类为ASA I-II级。关于疝的大小，143例患者（67.1%）存在小缺损（<3 cm）。选择的麻醉技术是局部麻醉加镇静。报告的并发症包括血清肿（5.6%）、血肿（2.3%）、伤口感染（1.4%）和对假体不耐受（0.95%），最后一项导致复发。平均随访64个月时的总体复发率为0.95%。成人脐疝人工修复术可安全进行，与原发性组织修复相比，本研究中的复发率较低。
