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腹壁重建:采用生物补片的腹部分离技术修复腹疝的病例系列。

Abdominal wall reconstruction: a case series of ventral hernia repair using the component separation technique with biologic mesh.

机构信息

Department of General Surgery, Rush University Medical Center, 1653 West Congress Parkway, Chicago, IL 60612, USA.

出版信息

Am J Surg. 2013 Mar;205(3):322-7; discussion 327-8. doi: 10.1016/j.amjsurg.2012.10.024. Epub 2013 Jan 22.

Abstract

BACKGROUND

Sixty-eight consecutive patients from October 2008 until February 2012 were selected for this retrospective review.

METHODS

A midline fascial closure with component separation was completed using biologic mesh onlay in all cases. Recurrence rates of the hernias, complication rates, patient satisfaction, and time to return to work/normal activities were investigated.

RESULTS

The recurrence rate was 1.5% (n = 65) with ongoing follow-ups (mean = 20 months). The average age was 57 years, and the average body mass index was 36 kg/m(2) (range 22 to 60). The average hernia defect was 20 cm (range 12 to 26) transversely. Wound infection and/or breakdown occurred in 32%, and seroma formation occurred in 9% of patients. Patient satisfaction was 3.63 of 4. The average time to return to work/normal activities was 16 weeks (range 1 to 76 weeks).

CONCLUSIONS

Large complex ventral hernias can be reliably repaired using the component separation technique. The short-term recurrence rate is significantly reduced in this case series using a biologic mesh onlay.

摘要

背景

从 2008 年 10 月至 2012 年 2 月,连续选择了 68 例患者进行回顾性研究。

方法

所有病例均采用生物补片行中线筋膜闭合和腹部分离技术。研究了疝的复发率、并发症发生率、患者满意度以及恢复工作/正常活动的时间。

结果

在持续随访(平均 20 个月)中,复发率为 1.5%(n=65)。平均年龄为 57 岁,平均体重指数为 36kg/m²(范围为 22 至 60)。疝缺损的平均横径为 20cm(范围为 12 至 26)。32%的患者发生伤口感染和/或裂开,9%的患者发生血清肿。患者满意度为 3.63(满分 4 分)。恢复工作/正常活动的平均时间为 16 周(范围为 1 至 76 周)。

结论

使用腹部分离技术可可靠地修复大型复杂腹疝。在本病例系列中,使用生物补片覆盖物可显著降低短期复发率。

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