Andreev S D, Adamian A A
Khirurgiia (Mosk). 1991 Oct(10):114-20.
The article deals with the results of surgical treatment of postoperative ventral hernias in 398 patients who underwent operation in 1982-1990; 68.5% of patients had large and giant hernias. In 198 patients (48.4%) the hernias were recurrent. One to 9 concomitant diseases were encountered in 88% of cases, which complicated the course of the postoperative period significantly. Reconstructive operations with the use of auto-allo-xenografts and netted synthetic materials were undertaken when the defect measured 15-20 cm in diameter, as well as in cases of multiple, though lesser in diameter, defects in patients with diseases of the cardiovascular system and lungs in the stage of sub- and decompensation, in hernias of long duration, in large irreducible hernias, and in patients over 60 years of age. A combination of grafts with netted synthetic materials was used when a defect measuring 21 cm or more in diameter was encountered together with the above situations. The late-term results were followed-up in periods of 12 months to 8 years. In 254 cases (69%) auto-allo-xenografts and synthetic materials and, in difficult situations, their combinations were used, with good results in 96% of patients. After plastics in 254 patients with the use of additional materials 2 recurrences (0.7%) were revealed; 3 recurrences (2.6%) were encountered among 113 cases in which the defect was closed with local tissues by means of sutures.
本文探讨了1982年至1990年间接受手术治疗的398例术后腹疝患者的手术治疗结果；68.5%的患者患有大型和巨型疝。198例患者（48.4%）的疝为复发性疝。88%的病例伴有1至9种合并疾病，这显著地使术后病程复杂化。当缺损直径为15至20厘米时，以及在心血管系统和肺部处于代偿不全和失代偿阶段的患者中出现多个（尽管直径较小）缺损、疝持续时间长、大型难复性疝以及60岁以上患者中，采用自体-异体-异种移植物和网状合成材料进行重建手术。当遇到直径为21厘米或更大的缺损并伴有上述情况时，采用移植物与网状合成材料相结合的方法。对患者进行了12个月至8年的远期结果随访。在254例（69%）患者中使用了自体-异体-异种移植物和合成材料，在困难情况下使用了它们的组合，96%的患者取得了良好效果。在254例使用了额外材料的患者进行整形手术后，发现2例复发（0.7%）；在113例通过缝合用局部组织关闭缺损的病例中，有3例复发（2.6%）。
