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使用生物补片修复因肿瘤侵犯导致的一处大型污染性腹壁缺损。病例报告。

The use of biological mesh to repair one large, contaminated abdominal wall defect due to neoplastic invasion. Report of a case.

作者信息

Galli Davide, Goi Gloria, Pariani Dario, Moroni Eliana, Danelli Piergiorgio

机构信息

Faculty of Medicine, University of Milan, Milan, Italy.

出版信息

Ann Ital Chir. 2012 Mar-Apr;83(2):167-9.

Abstract

We hereby report a case of use of biological mesh to repair one large, contaminated abdominal wall defect due to a sigmoid tumour presented as an abscess infiltrating the abdominal wall. Our patient was a 48-year-old woman. Her medical history was negative for any previous disease or surgical procedure. Because of the abscence of neoplastic secondarism an en-bloc resection of the interested sigmoid colon and of the infiltrated abdominal wall was performed, thus resulting a large wall defect in the left inguinal region. In order to close the wall defect a biological porcine collagen mesh was used. In our case we used a Permacol mesh made of porcine acellular dermal collagen. Reconstruction of complicated abdominal wall defects is a challenging surgical problem and primary repair is often difficult to achieve without excessive tension in the abdominal wall. The use of a syntethic mesh in this patient could have been inappropriate due to the possibility of creating adhesions with intra-abdominal viscera and fistula formation. We chose to use a biological mesh because of its safer properties in case of infected, inflamed or infiltrated surgical fields, as demonstrated in the literature.

摘要

我们在此报告一例使用生物补片修复因乙状结肠肿瘤导致的一个巨大、污染性腹壁缺损的病例,该肿瘤表现为脓肿并浸润腹壁。我们的患者是一名48岁女性。她既往无任何疾病或手术史。由于不存在肿瘤转移,对相关的乙状结肠和浸润的腹壁进行了整块切除,结果在左腹股沟区形成了一个巨大的腹壁缺损。为了闭合腹壁缺损,使用了生物猪胶原补片。在我们的病例中,我们使用的是由猪脱细胞真皮胶原制成的Permacol补片。复杂腹壁缺损的重建是一个具有挑战性的外科问题,在不造成腹壁过度张力的情况下,一期修复往往难以实现。在该患者中使用合成补片可能不合适,因为有可能与腹腔内脏器形成粘连并导致瘘管形成。正如文献中所表明的,由于在感染、炎症或浸润手术区域时生物补片具有更安全的特性,我们选择使用生物补片。

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