Witkowski P, Abbonante F, Fedorov I, Sledziński Z, Pejcic V, Slavin L, Adamonis W, Jovanovic S, Smietański M, Slavin D, Trabucco E E
Department of Surgery, Columbia University, New York, NY, USA.
Hernia. 2007 Dec;11(6):501-8. doi: 10.1007/s10029-007-0260-1. Epub 2007 Jul 27.
Avoiding mesh fixation to the surrounding tissue in ventral hernioplasty would simplify the operation, decrease the time of the procedure, and decrease the risk of suture-related complications.
Four hospitals included 111 patients according to the common protocol for prospective clinical evaluation of sutureless ventral hernioplasty. Surgical technique involves placement of the polypropylene mesh with flat-shape memory in either the retromuscular or preperitoneal space without suture anchoring.
Local complication rate was low (12.6%, 14 patients), postoperative pain measured according to the visual analogue scale was minimal (mean 4, range 1-8). Three recurrences (3%) were recorded. Mild scar discomfort, which did not require treatment nor limit physical activity, was recorded in 28 (25%), 18 (17%), and 11 (14%) patients at 6-month, 1- and 2-year follow-up, respectively.
Results of the study suggest that the sutureless sublay technique is safe and effective in the treatment of ventral abdominal hernia, especially in small and medium defects.
在腹疝修补术中避免将补片固定于周围组织可简化手术、缩短手术时间并降低与缝合相关的并发症风险。
根据无缝合腹疝修补术前瞻性临床评估的通用方案，四家医院纳入了111例患者。手术技术包括将扁平形状记忆的聚丙烯补片放置于肌后或腹膜前间隙，无需缝合固定。
局部并发症发生率较低（12.6%，14例患者），根据视觉模拟评分法测得的术后疼痛轻微（平均4分，范围1 - 8分）。记录到3例复发（3%）。在6个月、1年和2年随访时，分别有28例（25%）、18例（17%）和11例（14%）患者出现轻度瘢痕不适，但无需治疗且不限制体力活动。
研究结果表明，无缝合下层技术在治疗腹前壁疝方面安全有效，尤其适用于中小缺损。
