Department of Surgery, Reiner de Graaf Groep Delft, Reinier de Graafweg 3.11, 2625, AD, Delft, The Netherlands.
World J Surg. 2011 Nov;35(11):2399-402. doi: 10.1007/s00268-011-1249-6.
The surgical treatment of large midline incisional hernias remains a challenge. The aim of this report is to present the results of a new technique for large midline incisional hernia repair which combines the components-separation technique with a double-prosthetic-mesh repair.
The records of all consecutive patients who received a double-mesh combined with the components-separation technique for ventral hernia repair were reviewed. The clinical, surgical, and follow-up data were analyzed.
Nine patients [3 women, 6 men; median age = 62 years (range = 26-77)] were included in the study. Median transverse defect size was 20 cm (range = 15-25). The median duration of hospital stay was 8 days (range = 5-17). Postoperative complications occurred in 66% (6/9). Follow-up [median = 13 months (range = 3-49)] showed no recurrent hernias, but one patient had a small hernia after a relaparotomy for colon carcinoma recurrence. The overall occurrence of wound infections was 44% (4/9). There was no mortality.
The components-separation technique in combination with a double-mesh has shown a low recurrence rate in the short-term follow-up. However, there is a considerable occurrence of postoperative wound infections. Long-term results of the hernia recurrence rate have to be awaited.
大型中线切口疝的手术治疗仍然是一个挑战。本报告旨在介绍一种新的技术，该技术将分离技术与双补片修复相结合，用于治疗大型中线切口疝。
回顾了所有连续接受双网片结合腹疝修补分离技术的患者的记录。分析了临床、手术和随访数据。
本研究纳入了 9 例患者[3 例女性，6 例男性；中位年龄为 62 岁（范围 26-77 岁）]。中位横径缺损大小为 20cm（范围 15-25cm）。中位住院时间为 8 天（范围 5-17 天）。66%（6/9）的患者发生术后并发症。中位随访时间为 13 个月（范围 3-49 个月），无复发性疝，但 1 例患者因结肠癌复发再次剖腹手术后出现小疝。总的伤口感染发生率为 44%（4/9）。无死亡病例。
分离技术与双补片联合应用在短期随访中显示出较低的复发率。然而，术后伤口感染的发生率相当高。需要等待疝复发率的长期结果。
