腹内聚丙烯补片及新型补片用于腹疝修补术：循证医学有何见解？
Intra Peritoneal Polypropylene Mesh and Newer Meshes in Ventral Hernia Repair: What EBM Says?
作者信息
Ramakrishna H K, Lakshman K
机构信息
Lakshmi Nursing Home, New Bridge Road, Bhadravathi, 577301 India.
Sagar hospital, Bangalore, India.
出版信息
Indian J Surg. 2013 Oct;75(5):346-51. doi: 10.1007/s12262-012-0743-x. Epub 2012 Sep 26.
Abstract
Incisional hernias and other ventral hernias are common surgical problems. It is estimated that incisional hernia complicates about 2 % to 10 % of laparotomies. Ventral and incisional hernia repairs are among the common surgeries done by a general surgeon. It is proven beyond any doubt that suture repair of these hernias should not be done as recurrence rates are unacceptably high, some series reporting as high as 54 % on long-term follow-up. A prosthetic mesh should always be used in ventral hernia repair (VHR). Now, the polypropylene mesh (PPM) has become the prosthetic mesh of choice in the repair of hernias, including inguinal hernia. However, with the advent of laparoscopic repair where the mesh is placed intraperitoneally, concerns regarding safety of PPM are raised. Newer meshes are introduced, claiming lesser complication rate. Many types of newer meshes are available now. Newer meshes are invariably costlier than PPM by 15-20 times. Is this extra cost worth? We looked in to available literature for an answer.
摘要
切口疝和其他腹疝是常见的外科问题。据估计，切口疝在约2%至10%的剖腹手术中会出现并发症。腹疝和切口疝修补术是普通外科医生常做的手术之一。毫无疑问，这些疝的缝合修补不应进行，因为复发率高得令人难以接受，一些系列报道长期随访时复发率高达54%。腹疝修补术（VHR）应始终使用人工合成补片。如今，聚丙烯补片（PPM）已成为包括腹股沟疝在内的疝修补术中首选的人工合成补片。然而，随着腹腔镜修补术的出现，补片被放置在腹腔内，人们对PPM的安全性产生了担忧。新型补片被推出，声称并发症发生率更低。现在有许多类型的新型补片可供使用。新型补片的价格总是比PPM贵15至20倍。这笔额外的费用值得吗？我们查阅了现有文献以寻求答案。
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Intra Peritoneal Polypropylene Mesh and Newer Meshes in Ventral Hernia Repair: What EBM Says?腹内聚丙烯补片及新型补片用于腹疝修补术：循证医学有何见解？
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