Service de chirurgie digestive, oncologique et métabolique, hôpital Ambroise-Paré, AP-HP, 9, avenue Charles-de-Gaulle, 92100 Boulogne Billancourt, France; Université de Versailles Saint-Quentin-en-Yvelines, 78135 Versailles, France.
J Visc Surg. 2012 Oct;149(5 Suppl):e53-8. doi: 10.1016/j.jviscsurg.2012.07.007. Epub 2012 Nov 6.
Incisional hernia is one of the classic complications after abdominal surgery. The chronic, gradual increase in size of some of these hernias is such that the hernia ring widens to a point where there is a loss of substance in the abdominal wall, herniated organs can become incarcerated or strangulated while poor abdominal motility can alter respiratory function. The surgical treatment of small (<5 cm) incisional hernias is safe and straightforward, by either laparotomy or laparoscopy. For large hernias, surgical repair is often difficult. After reintegration of herniated viscera into the abdominal cavity, the abdominal wall defect must be closed anatomically in order to restore the function to the abdominal wall. Prosthetic reinforcement of the abdominal wall is mandatory for long-term successful repair. There are multiple techniques for prosthetic hernia repair, but placement of Dacron mesh in the retromuscular plane is our preference.
切口疝是腹部手术后的一种经典并发症。其中一些疝的慢性、逐渐增大，以至于疝环增宽到腹壁出现缺损，疝内容物可嵌顿或绞窄，而较差的腹部运动功能可改变呼吸功能。通过剖腹手术或腹腔镜手术，对小（<5cm）切口疝的手术治疗是安全且简单的。对于大疝，手术修复通常较为困难。在将疝出的内脏重新纳入腹腔后，必须解剖性地关闭腹壁缺损，以恢复腹壁功能。假体加强腹壁是长期成功修复的必要条件。有多种假体疝修复技术，但我们更喜欢在肌后平面放置涤纶网。
