van Eijck Floortje C, de Blaauw Ivo, Bleichrodt Robert P, Rieu Paul N M A, van der Staak Frans H J M, Wijnen Marc H W A, Wijnen Rene M H
Department of Surgery, Alysis Health Care, Location Rijnstate, Arnhem, The Netherlands.
J Pediatr Surg. 2008 Jan;43(1):246-50. doi: 10.1016/j.jpedsurg.2007.09.051.
BACKGROUND/PURPOSE: Several techniques have been described to repair giant omphaloceles. There is no procedure considered to be the criterion standard worldwide. The aim of the present prospective study was to analyze the early and late results of secondary closure of giant omphaloceles using the component separation technique (CST) in infants.
From January 2004 to January 2007, 10 consecutive pediatric patients with a giant omphalocele were treated at our department. Initially, patients were treated conservatively. After epithelialization of the omphalocele, the abdominal wall was reconstructed using CST. Patients were monitored for complications during admission, and all patients were seen for follow-up.
Component separation technique was performed at median age of 6.5 months (range, 5-69 months). The median diameter of the hernia was 8 cm (range, 6-9 cm). There was no mortality. The postoperative course was uneventful in 7 patients. Complications were seen in 3 patients (infection, skin necrosis, and hematoma). Median hospital stay was 7 days. After median follow-up of 23.5 months (range, 3-39 month), no reherniations were found.
The CST is a safe 1-stage procedure for secondary closure in children with a giant omphalocele without the need for prosthetic material and with good clinical outcome.
背景/目的：已有多种技术用于修复巨大脐膨出。目前尚无一种手术方法被公认为全球的标准术式。本前瞻性研究旨在分析采用腹壁组织分离技术（CST）对婴儿巨大脐膨出进行二期缝合的早期和远期效果。
2004年1月至2007年1月，我科连续收治了10例患有巨大脐膨出的儿科患者。最初，患者接受保守治疗。在脐膨出上皮化后，采用CST重建腹壁。住院期间对患者的并发症进行监测，所有患者均接受随访。
腹壁组织分离技术在患儿的中位年龄为6.5个月（范围5 - 69个月）时实施。疝的中位直径为8 cm（范围6 - 9 cm）。无死亡病例。7例患者术后病程顺利。3例患者出现并发症（感染、皮肤坏死和血肿）。中位住院时间为7天。中位随访23.5个月（范围3 - 39个月）后，未发现复发。
对于患有巨大脐膨出的儿童，腹壁组织分离技术是一种安全的一期二期缝合手术，无需使用人工材料，且临床效果良好。
