Fufezan V
Clinica de Chirurgie Pediatrică, I.M.F. Timişoara.
Rev Chir Oncol Radiol O R L Oftalmol Stomatol Chir. 1990 Jan-Feb;39(1):37-43.
Omphaloceles, as a malformation of the abdominal wall, is still a difficult problem for the surgeon. In the median and the large omphaloceles, when, besides other viscera, part or the entire liver will herniate surgical integration is only possible provided technical artifices are employed, and in progressive stages. Various therapeutical procedures have been attempted, beginning with the conservative ones, followed by covering of the viscera with skin, and, later on, with various plastics. All these procedures have a series of disadvantages, some of them being of long duration, and have only dubious results while other imply the risk of infection, and make necessary reinterventions. Our procedure, performed in 7 cases involves a two-stage resection of the nonvascular membrane, without interposition of foreign material. In the first surgical stage visceral integration is possible up to 2/3 of the volume of the omphaloceles. After 10-14 days the closure of the abdominal wall becomes possible. In the large omphaloceles, where eventration persists, the reparation of the abdominal wall should be carried out in 3-6 months.
脐膨出作为一种腹壁畸形,对外科医生来说仍是一个难题。在中位型和大型脐膨出中,当除其他内脏外,部分或整个肝脏也会疝出时,只有采用技术手段并在进展期才有可能进行手术整合。人们尝试了各种治疗方法,从保守治疗开始,接着是用皮肤覆盖内脏,后来又采用各种整形手术。所有这些方法都有一系列缺点,其中一些疗程漫长,效果也不确定,而另一些则有感染风险,还需要再次手术。我们对7例患者实施的手术包括分两阶段切除无血管膜,不植入异物。在第一阶段手术中,脐膨出体积的2/3以下的内脏有可能实现整合。10 - 14天后可以关闭腹壁。在大型脐膨出且仍有脏器突出的情况下,应在3 - 6个月内进行腹壁修复。