Department of Surgery, University Hospitals Case Medical Center, Case Western Reserve School of Medicine, Cleveland, OH, USA.
Am J Surg. 2011 Mar;201(3):396-400; discussion 400. doi: 10.1016/j.amjsurg.2010.08.023.
The appropriate surgical management of morbidly obese patients with symptomatic hernias is not well defined. The authors evaluated the role of simultaneous panniculectomy in complex abdominal wall reconstruction.
A retrospective study (2007-2010) was conducted of morbidly obese (body mass index > 40 kg/m(2)) patients undergoing open complex abdominal wall reconstruction.
Thirty patients were identified. Twenty underwent simultaneous panniculectomy. The median pannus weight was 5.2 kg. Greater all-cause postoperative complications and wound-related morbidity occurred in the panniculectomy group (P < .05). Performing a panniculectomy increased the risk for a wound complication by 5-fold (P = .04). Following 7-month to 9-month follow-up, both groups had a recurrence rate of 10%.
Simultaneous panniculectomy in the setting of complex abdominal wall reconstruction is feasible but associated with significant postoperative morbidity. Its potential for benefit in reducing long-term hernia recurrence remains unclear.
病态肥胖伴有症状疝患者的适当手术治疗尚未明确。作者评估了同时行腹脂切除术在复杂腹壁重建中的作用。
回顾性研究（2007-2010 年）分析了接受开放性复杂腹壁重建的病态肥胖（体重指数>40 kg/m(2))患者。
确定了 30 例患者。其中 20 例行同时行腹脂切除术。腹脂重量中位数为 5.2kg。腹脂切除术组的总术后并发症和伤口相关发病率更高（P<.05）。行腹脂切除术使伤口并发症的风险增加 5 倍（P=.04）。随访 7-9 个月后，两组复发率均为 10%。
在复杂腹壁重建中同时行腹脂切除术是可行的，但与显著的术后发病率相关。其降低长期疝复发的潜在获益尚不清楚。
