Scripcariu V, Timofeiov S, Dragomir Raluca, Lefter L, Radu I, Dragomir Cr
Universitatea de Medicină si Farmacie Gr.T. Popa Iaşi, Facultatea de Medicină, Clinica a III-a Chirurgicală.
Rev Med Chir Soc Med Nat Iasi. 2004 Oct-Dec;108(4):800-4.
Incisional hernia is an important complication of abdominal surgery. Procedures for the repair of these hernias with sutures and with mesh have been reported, but there is no consensus about which type of procedure is best. We have performed a retrospective analysis on 1014 patients operated on in our unit between 1994 and 2003 for simple or recurrent incisional hernias. The polypropylene mesh has been used in a number of 107 patients. The mesh has been placed either intraperitoneal, extraperitoneal/subfascial or onlay. Median follow-up was 36 months. There were 1 enterocutaneous fistula and 5 wound sinus developed. The mesh had to be removed in 6 cases. All of these complication developed when the mesh has been placed either extraperitoneal/subfascial or onlay. We note 5 recurrent incisional hernias after a period of up to 24 months. The recurrence rates after open mesh repair are less then after primary closure. The intraperitoneal use of polypropylene mesh with omental coverage is a good procedure with less complications.
切口疝是腹部手术的一种重要并发症。已有关于用缝线和补片修复这些疝的手术报道,但对于哪种手术方式最佳尚无共识。我们对1994年至2003年间在本单位接受手术的1014例单纯性或复发性切口疝患者进行了回顾性分析。107例患者使用了聚丙烯补片。补片放置于腹腔内、腹膜外/筋膜下或覆盖法。中位随访时间为36个月。出现了1例肠皮肤瘘和5例伤口窦道。6例患者的补片不得不被移除。所有这些并发症均发生在补片放置于腹膜外/筋膜下或覆盖法时。我们注意到在长达24个月的一段时间后有5例复发性切口疝。开放补片修补术后的复发率低于一期缝合术后。聚丙烯补片腹腔内使用并覆盖大网膜是一种并发症较少的良好手术方式。