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成人对成人活体肝移植受者的切口疝

Incisional hernia in recipients of adult to adult living donor liver transplantation.

作者信息

Ozgor Dincer, Dirican Abuzer, Ates Mustafa, Yilmaz Mehmet, Isik Burak, Yilmaz Sezai

机构信息

Department of General Surgery, Inonu University Faculty of Medicine, Malatya, Turkey.

出版信息

World J Surg. 2014 Aug;38(8):2122-5. doi: 10.1007/s00268-014-2528-9.

Abstract

BACKGROUND

After receiving a living donor liver transplant (LDLT), an incisional hernia is a potentially serious complication that can affect the patient's quality of life. In the present study we evaluated surgical hernia repair after LDLT.

MATERIALS AND METHODS

Medical records of patients who underwent surgery to repair an incisional hernia after LDLT in Turgut Ozal Medical Center between October 2006 and January 2010 were evaluated in this retrospective study. A reverse-T incision was made for liver transplantation. The hernias were repaired with onlay polypropylene mesh. Age, gender, post-transplant relaparatomy, the type, the result of surgery for the incisional hernia, and risk factors for developing incisional hernia were evaluated.

RESULTS

An incisional hernia developed in 44 of 173 (25.4%) patients after LDLT. Incisional hernia repair was performed in 14 of 173 patients (8.1%) who underwent LDLT from October 2006 to January 2010. Relaparatomy was associated with incisional hernia (p = 0.0002). The mean age at the time of the incisional hernia repair was 51 years, and 79% of the patients were men. The median follow-up period was 19.2 (13-36) months after the hernia repair. Three patients with intestinal incarceration underwent emergency surgery to repair the hernia. Partial small bowel resection was required in one patient. Postoperative complications included seroma formation in one patient and wound infection in another. There was no recurrence of hernia during the follow-up period.

CONCLUSIONS

The incidence of incisional hernia after LDLT was 25.4% in this study. Relaparatomy increases the probability of developing incisional hernia in recipients of LDLT. According to the results of the study, repair of an incisional hernia with onlay mesh is a suitable option.

摘要

背景

接受活体供肝移植(LDLT)后,切口疝是一种可能影响患者生活质量的严重并发症。在本研究中,我们评估了LDLT术后的手术疝修补情况。

材料与方法

在这项回顾性研究中,对2006年10月至2010年1月期间在图尔古特·奥扎尔医疗中心接受LDLT术后切口疝修补手术的患者的病历进行了评估。肝移植采用倒T形切口。疝修补采用聚丙烯补片覆盖修补。评估了患者的年龄、性别、移植后再次剖腹手术情况、切口疝的类型、手术结果以及发生切口疝的危险因素。

结果

173例LDLT患者中有44例(25.4%)发生了切口疝。2006年10月至2010年1月接受LDLT的173例患者中有14例(8.1%)进行了切口疝修补。再次剖腹手术与切口疝相关(p = 0.0002)。切口疝修补时的平均年龄为51岁,79%的患者为男性。疝修补术后的中位随访期为19.2(13 - 36)个月。3例发生肠嵌顿的患者接受了急诊疝修补手术。1例患者需要进行部分小肠切除术。术后并发症包括1例患者出现血清肿,另1例患者出现伤口感染。随访期间无疝复发。

结论

本研究中LDLT术后切口疝的发生率为25.4%。再次剖腹手术增加了LDLT受者发生切口疝的可能性。根据研究结果,采用补片覆盖修补切口疝是一种合适的选择。

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