Mittermair Reinhard P, Klingler Anton, Wykypiel Heinz, Gadenstätter Michael
Department of General Surgery, University Hospital Innsbruck, University of Innsbruck, Austria.
Eur J Surg. 2002;168(6):334-8. doi: 10.1080/11024150260284833.
To find out whether the vertical Mayo repair should be done for midline incisional hernias.
Retrospective study.
University hospital, Austria.
208 patients who presented with a primary midline incisional hernia during the period January 1991 to December 1996.
Incisional hernia repair using the vertical Mayo technique.
Recurrence rates, risk factors, common practice.
There were 60 recurrences (29%) and median follow up was 6 years (range 4-8). Four risk factors (cirrhosis, chronic cough, obesity (BMI > 30), and hernia width > 4 cm) were identified, which were independently predictive of hernia recurrence. All 60 patients with a recurrent hernia had at least two of the four risk factors. The remaining 148 patients who did not develop a recurrence had no risk factors, or only one. Recurrence could therefore be predicted with a sensitivity of 80% and a specificity of 96%.
The vertical Mayo repair is a good method for the repair of incisional hernias if not more than one of the four significant risk factors is present. The presence of two or more risk factors is predictive of a high rate of recurrence, and other techniques, such as alloplastic mesh repair, should be considered.
探讨中线切口疝是否应采用垂直梅奥修复术。
回顾性研究。
奥地利大学医院。
1991年1月至1996年12月期间出现原发性中线切口疝的208例患者。
采用垂直梅奥技术进行切口疝修补术。
复发率、危险因素、常见做法。
有60例复发（29%），中位随访时间为6年（范围4 - 8年）。确定了四个危险因素（肝硬化、慢性咳嗽、肥胖（BMI>30）和疝宽度>4 cm），这些因素可独立预测疝复发。所有60例复发疝患者至少有四个危险因素中的两个。其余148例未复发的患者没有危险因素，或只有一个危险因素。因此，复发可通过80%的敏感性和96%的特异性进行预测。
如果四个重要危险因素中不超过一个存在，垂直梅奥修复术是修复切口疝的好方法。存在两个或更多危险因素预示着高复发率，应考虑其他技术，如异体网片修复术。
