Department of General Surgery, Sant'Elena Clinic, Cagliari, Italy.
Am J Surg. 2011 Jul;202(1):e7-11. doi: 10.1016/j.amjsurg.2010.06.005. Epub 2011 May 19.
The aim of this study was to determine the feasibility and efficacy of repairing large abdominal incisional hernias by reconstructing the midline using bilateral abdominis rectus muscle sheath (ARS) relaxing incisions and a biological material onlay.
Between January 2002 and December 2008, 71 patients underwent repair of large incisional hernias at 2 community hospitals. After replacement of hernia sac contents into the peritoneal cavity, a relaxing incision was made in the ARS bilaterally. Then, the midline was closed primarily. The biological material was used as an onlay and sutured to the lateral edges of the relaxed ARS. Main outcome measures were postoperative complications and hernia recurrence.
Median defect size was 195 cm(2) (range, 150-420 cm(2)), median surgical time was 125 minutes, and median hospital stay was 6 days. There were no deaths and no wound infections. Wound seroma, the most frequent postoperative complication, occurred in 51 (72%) of the 71 patients. There was 1 (1.4%) recurrence.
In these 71 patients, our technique for repair of large abdominal incisional hernias was safe and effective.
本研究旨在探讨使用双侧腹直肌鞘（ARS）松解切口和生物材料覆盖物重建中线来修复大型腹部切口疝的可行性和疗效。
2002 年 1 月至 2008 年 12 月期间，在 2 家社区医院对 71 例大型切口疝患者进行了修复。在将疝囊内容物放回腹腔后，双侧 ARS 行松解切口。然后，中线直接关闭。生物材料作为覆盖物，缝合到放松的 ARS 的外侧边缘。主要观察指标为术后并发症和疝复发。
中位缺损大小为 195cm²（范围，150-420cm²），中位手术时间为 125 分钟，中位住院时间为 6 天。无死亡病例，无伤口感染。最常见的术后并发症为伤口血清肿，发生于 71 例患者中的 51 例（72%）。有 1 例（1.4%）复发。
在这 71 例患者中，我们修复大型腹部切口疝的技术是安全有效的。
