Kuznetsov N A, Schastlivtsev I V, Tsaplin S N
Khirurgiia (Mosk). 2011(7):62-6.
Long-term follow-up of 508 patients after various surgical procedures has been conducted. Of the 351 patients were operated on using a paramedian incision, 109 had an upper median laparotomy and the rest 48 had an oblique subcostal incision. Post-operative ventral hernias were registered in 45 (8.86%) patients. The upper median laparotomy herniated in 18 (16.51%) patients, paramedian incision - in 17 (4.84%), and the oblique subcostal incision herniated in 10 (20.83%). Hernia was noticed by the patient within 12 months after the initial operation in 46.67%, of them in 85.71% - within first 6 months. 53,33% of patients were diagnosed with postoperative hernia only after thorough examination. Thus, paramedian incision is considered to be the most preferable access. Postoperative hernias develop within the first 6-12 months postoperatively, later hernia registration is a result of poor examination.
对508例接受各种外科手术后的患者进行了长期随访。在351例采用旁正中切口进行手术的患者中,109例接受了上腹部正中剖腹术,其余48例采用肋下斜切口。45例(8.86%)患者出现术后腹疝。上腹部正中剖腹术患者中有18例(16.51%)出现疝,旁正中切口患者中有17例(4.84%)出现疝,肋下斜切口患者中有10例(20.83%)出现疝。46.67%的患者在初次手术后12个月内被患者发现有疝,其中85.71%在最初6个月内被发现。53.33%的患者仅在全面检查后才被诊断为术后疝。因此,旁正中切口被认为是最可取的入路。术后疝在术后最初6至12个月内发生,后期疝的发现是检查不充分的结果。