Kumar Vikram, Rodrigues Gabriel, Ravi Chandni, Kumar Sampath
Department of General Surgery, Kasturba Medical College, Manipal University, Manipal, 576 104 Karnataka India.
Indian J Surg. 2013 Aug;75(4):271-3. doi: 10.1007/s12262-012-0644-z. Epub 2012 Jul 4.
This prospective study was conducted at a tertiary care teaching hospital in South India over a period of 7 years and included 90 patients with incisional hernia (n = 90; 76 females and 14 males), operated over 2 years (January 2004 to December 2005), and followed-up for 5 years postoperatively (2005-2009). As per the surgical unit preference, patients underwent different methods of hernia repair-onlay mesh repair (n = 45, 50 %), underlay mesh repair (n = 18, 20 %), and anatomical repair (i.e., without mesh) (n = 27, 30 %). Parameters studied included seroma formation, wound infection, postoperative pain, and hernia recurrence. Although the first two parameters were statistically not significant, postoperative pain was found to be more in patients who underwent an underlay repair. A significant difference in the hernia recurrence rate was observed between mesh repair and anatomical repair groups. Hence, we conclude that all incisional hernias should be repaired with a mesh (meshplasty).
这项前瞻性研究在印度南部的一家三级护理教学医院进行,为期7年,纳入了90例切口疝患者(n = 90;76例女性和14例男性),这些患者在2年时间内(2004年1月至2005年12月)接受了手术,并在术后进行了5年随访(2005 - 2009年)。根据手术科室的偏好,患者接受了不同的疝修补方法——补片外置修补术(n = 45,50%)、补片内置修补术(n = 18,20%)和解剖修复术(即不使用补片)(n = 27,30%)。研究的参数包括血清肿形成、伤口感染、术后疼痛和疝复发。虽然前两个参数在统计学上无显著差异,但发现接受内置修补术的患者术后疼痛更明显。在补片修补组和解剖修复组之间观察到疝复发率有显著差异。因此,我们得出结论,所有切口疝均应采用补片进行修补(补片成形术)。