Israelsson L A, Smedberg S, Montgomery A, Nordin P, Spangen L
Department of Surgery and Perioperative Science, Umeå University, Umeå, Sweden.
Hernia. 2006 Jun;10(3):258-61. doi: 10.1007/s10029-006-0084-4. Epub 2006 Mar 23.
Incisional hernia is a common problem after abdominal surgery. The complication and recurrence rates following the different repair techniques are a matter of great concern. Our aim was to study the results of incisional hernia repair in Sweden. A questionnaire was sent to all surgical departments in Sweden requesting data concerning incisional hernia repair performed during the year 2002. Eight hundred and sixty-nine incisional hernia repairs were reported from 40 hospitals. Specialist surgeons performed the repair in 782 (83.8%) patients. The incisional hernia was a recurrence in 148 (17.0%) patients. Thirty-three per cent of the hernias were subsequent to transverse, subcostal or muscle-splitting incisions or laparoscopic procedures. Suture repair was performed in 349 (40.2%) hernias. Onlay mesh repair was more common than a sublay technique. The rate of wound infection was 9.6% after suture repair and 8.1% after mesh repair. The recurrence rate was 29.1% with suture repair, 19.3% with onlay mesh repair, and 7.3% with sublay mesh repair. This survey revealed that there is room for improvement regarding the incisional hernia surgery in Sweden. Suture repair, with its unacceptable results, is common and mesh techniques employed may not be optimal. This study has led to the instigation of a national incisional hernia register.
切口疝是腹部手术后的常见问题。不同修复技术后的并发症和复发率备受关注。我们的目的是研究瑞典切口疝修复的结果。向瑞典所有外科科室发送了一份问卷,要求提供2002年期间进行的切口疝修复数据。40家医院报告了869例切口疝修复手术。782例(83.8%)患者由专科外科医生进行修复。148例(17.0%)患者的切口疝为复发。33%的疝继发于横切口、肋下切口、肌肉劈开切口或腹腔镜手术。349例(40.2%)疝采用缝合修复。补片修补术比衬层修补术更常见。缝合修复后伤口感染率为9.6%,补片修补后为8.1%。缝合修复的复发率为29.1%,补片修补术为19.3%,衬层补片修补术为7.3%。这项调查显示,瑞典的切口疝手术仍有改进空间。结果难以接受的缝合修复很常见,所采用的补片技术可能并非最佳。这项研究促使建立了一个全国性的切口疝登记册。