用于切口疝修补的腹壁重建。
Reconstruction of the abdominal wall for incisional hernia repair.
作者信息
Espinosa-de-Los-Monteros Antonio, de la Torre Jorge I, Ahumada Leonik A, Person David W, Rosenberg Laurence Z, Vásconez Luis O
机构信息
Division of Plastic Surgery, University of Alabama at Birmingham, Birmingham, AL, USA.
出版信息
Am J Surg. 2006 Feb;191(2):173-7. doi: 10.1016/j.amjsurg.2005.07.037.
BACKGROUND
Abdominal wall reconstruction with mobilization of autologous tissue has evolved as a reliable option for patients with incisional hernias.
METHODS
With the aim of evaluating morbidity and recurrence rates in patients who underwent abdominal wall reconstruction for incisional hernia repair, we retrospectively reviewed the charts of 188 patients treated between 1996 and 2003.
RESULTS
Primary approximation of the fascial defect was achieved in 77% and was reinforced by either mesh placement or rectus muscle advancement. The remaining 23% were reconstructed either by mesh placement, components separation, or distant flap mobilization. Median follow-up was 15 months. Overall morbidity rate was 38%; recurrence rate was 13%. Dimensions of the hernia and intraoperative enterotomies were associated with postoperative complications. Lack of complete restoration of the myofascial abdominal wall continuity was associated with recurrence.
CONCLUSIONS
In patients with incisional hernias, techniques involving autologous tissue mobilization are safe and associated with low recurrence rates.
背景
利用自体组织移位进行腹壁重建已成为治疗切口疝患者的一种可靠选择。
方法
为了评估接受腹壁重建以修复切口疝患者的发病率和复发率，我们回顾性分析了1996年至2003年间接受治疗的188例患者的病历。
结果
77%的患者实现了筋膜缺损的一期缝合，并通过放置补片或腹直肌移位进行了加强。其余23%的患者通过放置补片、组织分离或远处皮瓣移位进行了重建。中位随访时间为15个月。总体发病率为38%；复发率为13%。疝的大小和术中肠切开与术后并发症相关。肌筋膜腹壁连续性未完全恢复与复发相关。
结论
对于切口疝患者，涉及自体组织移位的技术是安全的，且复发率低。
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