Department of General Surgery, AZ Maria Middelares, Kortrijksesteenweg 1026, 9000, Ghent, Belgium.
Hernia. 2011 Aug;15(4):463-8. doi: 10.1007/s10029-010-0692-x. Epub 2010 Jun 17.
Several mesh devices for the treatment of umbilical and other small ventral hernias have become available in recent years. These meshes have a dual layer consisting of a permanent or temporary barrier against adhesion formation between the viscera and the intraperitoneally exposed part of the mesh. We have seen several patients with serious late complications of these meshes placed intraperitoneally. Some of these patients needed small bowel resection and mesh removal. Others developed a recurrence because of improper deployment of the mesh in the intraperitoneal position. We think that, if preperitoneal deployment of such mesh devices is possible, this should be the preferred position, notwithstanding the fact that these meshes have a dual layer. There is a complete lack of convincing data on these mesh devices in the medical literature. No long-term data have been published, and, for three of the four mesh devices available, no publications on their use in humans were found. We think that surgeons adopting innovative mesh devices should register and follow their patients prospectively, at least until there are enough published studies with sufficiently large patient samples, acceptable follow up times, and favourable outcomes.
近年来,有几种用于治疗脐疝和其他小型腹侧疝的网片问世。这些网片有双层结构,由一个永久性或临时性的屏障组成,以防止内脏与网片腹膜内暴露部分之间的粘连形成。我们已经看到了一些因这些网片在腹膜内放置而出现严重晚期并发症的患者。其中一些患者需要进行小肠切除术和网片切除。另一些患者则因网片在腹膜内位置不当而复发。我们认为,如果可以将这些网片装置预先置于腹膜前,那么这应该是首选位置,尽管这些网片有双层结构。在医学文献中,这些网片装置缺乏令人信服的数据。没有长期数据发表,而且在可获得的四种网片装置中,有三种没有找到关于其在人体中使用的出版物。我们认为,采用创新性网片装置的外科医生应该对其患者进行前瞻性登记和随访,至少要等到有足够多的发表研究具有足够大的患者样本、可接受的随访时间和良好的结果为止。