Department of Pediatric Surgery and Center for Surgical Trials and Evidence-based Practice, University of Texas Medical School at Houston and The Children's Memorial Hermann Hospital, Houston TX.
J Pediatr Surg. 2013 Dec;48(12):2525-9. doi: 10.1016/j.jpedsurg.2013.05.067.
Operative repair of large abdominal wall defects in infants and children can be challenging. Component separation technique (CST) is utilized in adults to repair large abdominal wall defects but rarely used in children. The purpose of this report is to describe our experience with the CST in pediatric patients including the first description of CST use in newborns.
After IRB approval, we reviewed all patients who underwent CST between June 1, 2010 and December 31, 2012 at a large children's hospital. CST included dissection of abdominal wall subcutaneous tissue from the muscle and fascia and an incision of the external oblique aponeurosis one centimeter lateral to the rectus sheath. Biologic mesh onlay or underlay was used to reinforce this closure. Patients were followed for complications.
Nine children, two patients with gastroschisis and seven with omphalocele, were repaired with CST at median (range) 1.1 years (5 days-10.1 years) of age. CST was the first surgical intervention for five children. There were minor wound complications and no recurrences after a median (range) follow up of 16 months (3-34 months).
CST can be a very useful technique to repair large abdominal wall defects in children with a loss of abdominal domain.
婴幼儿大腹壁缺损的手术修复具有挑战性。成人采用分离技术（CST）修复大腹壁缺损，但在儿童中很少使用。本报告旨在描述我们在小儿患者中使用 CST 的经验，包括首次描述 CST 在新生儿中的应用。
在获得机构审查委员会批准后，我们回顾了 2010 年 6 月 1 日至 2012 年 12 月 31 日期间在一家大型儿童医院接受 CST 的所有患者。CST 包括从肌肉和筋膜分离腹壁皮下组织，并在腹直肌鞘外侧 1 厘米处切开外斜肌腱膜。生物网片覆盖或衬里用于加强这种闭合。患者接受并发症随访。
9 名儿童，2 名先天性脐膨出和 7 名腹裂患儿，在中位（范围）1.1 岁（5 天至 10.1 岁）时接受 CST 修复。5 名患儿为 CST 的首次手术干预。中位（范围）随访 16 个月（3-34 个月）后，仅出现轻微伤口并发症，无复发。
CST 对于因腹部区域丧失而导致的大腹壁缺损的儿童来说是一种非常有用的技术。
