Machairas Anastasios, Misiakos Evangelos P, Liakakos Theodore, Karatzas Gabriel
3rd Department of Surgery, University of Athens, Faculty of Medicine, Attikon University Hospital, Athens, Greece.
Am Surg. 2004 Aug;70(8):726-9.
Recurrent incisional hernia remains a major problem for the general surgeon. The high recurrence rate of incisional hernias after primary closure by tissue approximation led to the development of tension-free procedures using prosthetic materials. The goal of this study is to present the results of an extraperitoneal tension-free technique using a polyester mesh (Mersilene). A total of 43 patients with incisional hernias were surgically treated during a 9-year period in our department. Twenty-four patients (56%) had recurrent incisional hernias, 21 had primary repair by tissue approximation, and 3 had prolene mesh tension-free repair with wound infection. Patients' mean age was 68.2 years, and the mean postoperative follow-up was 54.4 months. Immediate postoperative complications were noticed in 9 patients (21%) subcutaneous seroma in 6 (14%) and wound infection in 3 (7%). Recurrence was noticed in 4 patients (9%) during the first 9 postoperative months. Late minor complications such as restriction of abdominal wall motility and chronic pain was noticed in 3 (7%) patients. In conclusion, the extraperitoneal onlay tension-free incisional hernia repair using polyester mesh is an easy and safe procedure with no major morbidity or recurrence rate.
复发性切口疝仍然是普通外科医生面临的一个主要问题。通过组织对合进行一期缝合后切口疝的高复发率促使了使用人工材料的无张力手术的发展。本研究的目的是展示使用聚酯网片(Mersilene)的腹膜外无张力技术的结果。在我们科室的9年期间,共有43例切口疝患者接受了手术治疗。24例患者(56%)患有复发性切口疝,21例通过组织对合进行了一期修复,3例采用普理灵网片无张力修复但发生了伤口感染。患者的平均年龄为68.2岁,术后平均随访时间为54.4个月。9例患者(21%)出现了术后即刻并发症,其中6例(14%)为皮下血清肿,3例(7%)为伤口感染。4例患者(9%)在术后前9个月出现复发。3例(7%)患者出现了如腹壁活动受限和慢性疼痛等晚期轻微并发症。总之,使用聚酯网片进行腹膜外覆盖无张力切口疝修补术是一种简单且安全的手术,无严重并发症或复发率。