Department of General Surgery, Faculty of Medicine, University of Alexandria, 20 Ismail Serry St., Semouha, Alexandria, Egypt.
Hernia. 2013 Feb;17(1):59-65. doi: 10.1007/s10029-012-0938-x. Epub 2012 Jun 26.
The aim of this prospective study was to present a 7-year experience with the use of prosthetic mesh repair in the management of the acutely incarcerated and/or strangulated ventral hernias.
Patients with acutely incarcerated and/or strangulated ventral hernias were treated by emergency repair of the hernia using an onlay Prolene mesh. The presence of non-viable intestine necessitating resection-anastomosis of the bowel was not considered a contraindication to the use of mesh.
The present study included 80 patients. Their age ranged from 25 to 86 years with a mean of 56.1 ± 13.2 years. The hernia was para-umbilical in 71 patients (88.75 %), epigastric in 6 patients (7.5 %) and incisional in 3 patients (3.75 %). Eighteen patients (22.5 %) had recurrent hernias. Resection-anastomosis of non-viable small intestine was performed in 18 patients (22.5 %). There were 2 perioperative mortalities (2.5 %). Complications were encountered in 17 patients (21.3 %) and included wound sepsis in 9 patients (11.25 %), seroma formation in 5 patients (6.25 %), chest infection in 4 patients (5 %), deep vein thrombosis in 1 patient (1.25 %) and mesh infection in another patient (1.25 %). Follow-up duration ranged from 12 to 84 months with a mean of 49.9 ± 19.9 months. Only one recurrence was encountered throughout the study period.
The use of prosthetic mesh repair in the emergency management of the acutely incarcerated and/or strangulated ventral hernias is safe. The presence of non-viable intestine cannot be regarded as a contraindication for prosthetic repair.
本前瞻性研究旨在介绍使用补片修补术治疗急性嵌顿和/或绞窄性腹疝的 7 年经验。
对急性嵌顿和/或绞窄性腹疝患者行疝修补术，采用 Prolene 网片行疝修补术。肠坏死需要进行肠切除吻合术的患者，不视为使用补片的禁忌证。
本研究共纳入 80 例患者，年龄 25 至 86 岁，平均年龄 56.1 ± 13.2 岁。71 例（88.75%）患者的疝位于脐旁，6 例（7.5%）位于上腹部，3 例（3.75%）位于切口。18 例（22.5%）患者为复发性疝。18 例（22.5%）患者行非存活小肠切除吻合术。2 例（2.5%）患者围手术期死亡。17 例（21.3%）患者出现并发症，包括 9 例（11.25%）切口感染、5 例（6.25%）血清肿形成、4 例（5%）胸部感染、1 例（1.25%）深静脉血栓形成和 1 例（1.25%）补片感染。随访时间 12 至 84 个月，平均 49.9 ± 19.9 个月。研究期间仅 1 例复发。
在急性嵌顿和/或绞窄性腹疝的紧急处理中使用补片修补术是安全的。肠坏死不能被视为补片修复的禁忌证。
