Saxe Andrew, Schwartz Scott, Gallardo Lori, Yassa Eanas, Alghanem Abd
Department of Surgery, McLaren Regional Medical Center, Flint Michigan and Michigan State University, 1200 East Michigan Avenue, Suite 655, East Lansing, MI 48912, USA.
Obes Surg. 2008 Feb;18(2):192-5; discussion 196. doi: 10.1007/s11695-007-9344-3. Epub 2008 Jan 5.
Successful obesity surgery often results months later in redundant abdominal skin and subcutaneous tissue. Following open obesity surgery, ventral hernias are also common, yet little has been written about the safety of combining panniculectomy with ventral hernia repair. We performed a retrospective analysis of a single plastic surgeon's experience with panniculectomy following gastric bypass surgery including both patients undergoing and those not undergoing simultaneous ventral hernia repair.
We reviewed the hospital and office records of patients undergoing panniculectomy at two university-affiliated community hospitals from March 2002 to February 2005 following gastric bypass surgery.
The records of 100 patients (91 women) were available for review. Median age was 48 (range 25-65) and median interval between bypass surgery and panniculectomy was 23 months (range 6-286). Median decrease in BMI was 19 (range 13-47). Eighty-three patients underwent panniculectomy combined with at least one other procedure, most commonly ventral hernia repair (70) and buttock lift (9). Forty hernia repairs were performed with mesh. No patient required mesh removal in the postoperative period. Median length of hospital stay was 3 days (range 1-7). Twenty-nine patients required outpatient sharp debridement. Ten patients were readmitted for management of wound complications. No patients sustained a stroke, myocardial infarction, or pulmonary embolus. There was no mortality.
Following obesity surgery, simultaneous ventral hernia repair and panniculectomy can be accomplished safely with short hospital stays and few in-hospital complications. Postoperative wound problems are not infrequent but can be managed in the outpatient setting.
成功的肥胖症手术通常在数月后会导致腹部皮肤和皮下组织冗余。开放性肥胖症手术后，腹疝也很常见，但关于腹壁成形术与腹疝修补术联合应用的安全性的报道较少。我们对一位整形外科医生在胃旁路手术后进行腹壁成形术的经验进行了回顾性分析，包括接受和未接受同期腹疝修补术的患者。
我们回顾了2002年3月至2005年2月在两家大学附属医院社区医院接受胃旁路手术后进行腹壁成形术的患者的医院和门诊记录。
有100例患者（91名女性）的记录可供审查。中位年龄为48岁（范围25 - 65岁），旁路手术与腹壁成形术之间的中位间隔时间为23个月（范围6 - 286个月）。BMI的中位下降值为19（范围13 - 47）。83例患者接受了腹壁成形术并至少联合了一项其他手术，最常见的是腹疝修补术（70例）和臀部提升术（9例）。40例疝修补术使用了补片。术后没有患者需要取出补片。中位住院时间为3天（范围1 - 7天）。29例患者需要门诊锐性清创。10例患者因伤口并发症再次入院。没有患者发生中风、心肌梗死或肺栓塞。无死亡病例。
肥胖症手术后，同期腹疝修补术和腹壁成形术可以安全完成，住院时间短且院内并发症少。术后伤口问题并不罕见，但可在门诊处理。
