Unit of General Surgery, Papa Giovanni XXIII hospital, P.zza OMS 1, 24127, Bergamo, Italy,
Updates Surg. 2013 Sep;65(3):191-6. doi: 10.1007/s13304-013-0212-5. Epub 2013 May 1.
The risk of fascial dehiscence, wound infection and incisional hernias in organ recipients is higher. Retrospective analysis of our departments database, checking the last 12 years (2000-2012), and of the literature (1966-2012) were conducted. In our database we found seven patients: five liver (71.4 %), one kidney (14.3 %), one multivisceral (14.3 %); five males (71.4 %), two females (28.6 %). Five (71.4 %) were operated in urgency setting and two in ordinary setting (28.6 %). The mean/median number of laparotomies before the incisional hernia is of 2.1/1 (range 1-5). In five patients swine intestinal submucosa (71.4 %) have been used and in two porcine dermal collagen (28.6 %). The mean/median age was 48.3/52 years (range 18-61). The mean/median body mass index was 26.7/27 (range 19-34). The mean/median for follow-up after intervention was 40.1/33 months (range 50-21). Recurrence rate was 14.3 %. Complication rate was 28.6 %. Adding the present report, the literature reports 70 cases. 20 % of prosthesis have been implanted inlay, 25.7 % underlay, in 5.7 % intraperitoneal and in 48.6 % were not specified. The mean age ranges from 0.7 to 48.3 years. Kidney, liver, pancreas, bowel and multivisceral transplant are reported. Porcine dermal collagen has been implanted in 24.3 %, human dermal collagen in 51.4 % and swine intestinal submucosa in 24.3 %. The immunosuppression regimens comprehend variable associations of tacrolimus, steroids, mycophenolate mofetil, sirolimus, thymoglobulin, azathioprine/basiliximab and daclizumab. The mean follow-up is 16.2 months. The mean complication rate is 9.4 %. Biological prosthesis seems to be useful and safe in abdominal wall repair surgery in transplanted patients.
器官接受者的筋膜裂开、伤口感染和切口疝的风险更高。我们对部门数据库进行了回顾性分析，检查了过去 12 年（2000-2012 年），并对文献（1966-2012 年）进行了回顾。在我们的数据库中，我们发现了 7 名患者：5 名肝（71.4%），1 名肾（14.3%），1 名多器官（14.3%）；5 名男性（71.4%），2 名女性（28.6%）。5 名（71.4%）在紧急情况下进行手术，2 名在普通情况下进行手术（28.6%）。发生切口疝之前的剖腹手术次数平均/中位数为 2.1/1（范围 1-5）。5 名患者（71.4%）使用了猪肠黏膜下层，2 名患者（28.6%）使用了猪真皮胶原。平均/中位数年龄为 48.3/52 岁（范围 18-61）。平均/中位数体重指数为 26.7/27（范围 19-34）。干预后平均/中位数随访时间为 40.1/33 个月（范围 50-21）。复发率为 14.3%。并发症发生率为 28.6%。加上本次报告，文献报道了 70 例。20%的假体为嵌入式，25.7%为衬垫式，5.7%为腹腔内，48.6%未明确。平均年龄范围为 0.7-48.3 岁。报告了肾、肝、胰腺、肠和多器官移植。猪真皮胶原植入 24.3%，人真皮胶原植入 51.4%，猪肠黏膜下层植入 24.3%。免疫抑制方案包括他克莫司、类固醇、霉酚酸酯、西罗莫司、胸腺球蛋白、硫唑嘌呤/巴利昔单抗和达克珠单抗的各种联合。平均随访时间为 16.2 个月。平均并发症发生率为 9.4%。生物假体在移植患者的腹壁修复手术中似乎是有用且安全的。
