Mavrodin C M, Pariza G, Ion D, Ciurea M
Emergency Hospital Bucharest.
J Med Life. 2014 Mar 15;7(1):90-3. Epub 2014 Mar 25.
Incisional hernias are a common complication of abdominal surgery. Research shows that their incidence reaches 10%-11% of the total number of patients subject to laparotomy. Recurrent hernias are the main complication of eventrations and its rate ranges from 5 to 54%, depending on both the surgical procedure used and the follow-up methods. The goal of this study is the comparative cost analysis of two procedures used in the treatment of event rations, tissular versus alloplastic, the former, leading very often to recurrence requiring a new surgical intervention. The analysis comprised 156 cases of surgeries performed for incisional hernia in 2007 in the clinic of Surgery III, SUUB (Bucharest University Emergency Hospital). Tissular procedures were used in 42 cases and prosthetic procedures in 114 cases. The medium-term postoperative follow-up has revealed 17 relapses (40.4%) in the tissular batch and no relapse in the batch where parietal prosthesis was used. If the short-term costs of the tissular procedures are low as compared with the prosthetic procedures, on the medium-term the costs increase by 24.35% due to the high rate of relapses of tissular procedures. Therefore, the tissular procedure must be abandoned due to the high rate of relapse, as this drives additional costs required for the alloplastic repair of the abdominal parietal defects in a subsequent surgical intervention.
切口疝是腹部手术常见的并发症。研究表明，其发生率占接受剖腹手术患者总数的10%-11%。复发性疝是切口疝的主要并发症，其发生率在5%至54%之间，这取决于所采用的手术方式和随访方法。本研究的目的是对两种治疗切口疝的手术方法进行成本比较分析，即组织修补术和人工材料修补术，前者常常导致复发，需要再次进行手术干预。该分析涵盖了2007年在布加勒斯特大学急诊医院第三外科诊所进行的156例切口疝手术病例。其中42例采用了组织修补术，114例采用了假体修补术。术后中期随访显示，组织修补组有17例复发（40.4%），而使用腹壁假体的组未出现复发。如果组织修补术的短期成本与假体修补术相比很低，但从中期来看，由于组织修补术的高复发率，成本会增加24.35%。因此，由于复发率高，组织修补术必须摒弃，因为这会导致后续手术中腹壁缺损的人工材料修复所需的额外费用。
