Sauerland S, Korenkov M, Kleinen T, Arndt M, Paul A
Department of Surgery, University of Cologne, Ostmerheimer Strasse 200, D-51109, Köln, Germany.
Hernia. 2004 Feb;8(1):42-6. doi: 10.1007/s10029-003-0161-x. Epub 2003 Sep 6.
Any individualisation of incisional hernia repair requires a profound knowledge of risk factors for recurrence.
A series of 160 patients underwent incisional hernia repair and were prospectively followed up at 3, 6, 12, and 24 months after surgery. We analysed the importance of various variables to predict recurrence.
An overall recurrence rate of 11% ( n=17) was observed. The risk for recurrence was not significantly affected by any of the clinical variables except for obesity ( P=0.03). Even when controlling for the influence of age, gender, hernia size, and surgical technique, obesity remained a significant predictor with a rate ratio of 1.10 per unit BMI (95%-CI: 1.02-1.18; P=0.01).
This and other studies found hernia recurrence to be more likely in obese patients. Probably, such patients, therefore, should receive mesh rather than suture repair.
切口疝修补的任何个体化治疗都需要对复发风险因素有深入了解。
160例患者接受了切口疝修补术,并在术后3、6、12和24个月进行前瞻性随访。我们分析了各种变量对预测复发的重要性。
观察到总体复发率为11%(n = 17)。除肥胖外,任何临床变量对复发风险均无显著影响(P = 0.03)。即使在控制年龄、性别、疝大小和手术技术的影响后,肥胖仍然是一个显著的预测因素,每单位BMI的发生率比为1.10(95%置信区间:1.02 - 1.18;P = 0.01)。
本研究及其他研究发现肥胖患者疝复发的可能性更大。因此,这类患者可能应接受补片修补而非缝合修补。