使用补片进行脐疝修补术：确定理想预后的影响因素。

Umbilical hernia repair with mesh: identifying effectors of ideal outcomes.

作者信息

Colavita Paul D, Belyansky Igor, Walters Amanda L, Zemlyak Alla Y, Lincourt Amy E, Heniford B Todd, Augenstein Vedra A

机构信息

Division of Gastrointestinal and Minimally Invasive Surgery, Carolinas Laparoscopic and Advanced Surgery Program, Carolinas Medical Center, Charlotte, NC, USA.

出版信息

Am J Surg. 2014 Sep;208(3):342-9. doi: 10.1016/j.amjsurg.2013.12.031. Epub 2014 Apr 3.

DOI:10.1016/j.amjsurg.2013.12.031

PMID:24793575

Abstract

BACKGROUND

Quality of life has become an important focus for improvement in hernia repair.

METHODS

The International Hernia Mesh Registry was queried. The Carolinas Comfort Scale quantitated quality of life at 1-month, 6-month, and annual follow-up. Scores of 0 (completely asymptomatic) in all categories without recurrence defined an ideal outcome.

RESULTS

The analysis consisted of 363 umbilical hernia repairs; 18.7% were laparoscopic. Demographics included age of 51.5 ± 13.8 years, 24.5% were female, and the average body mass index was 30.63 ± 5.9 kg/m(2). Mean defect size was 4.3 ± 3.1 cm(2). Mean follow-up was 18.2 months. Absent/minimal preoperative symptoms were predictive of ideal outcome at all time points and increasing age was predictive at 6 months and 1 year. At 6 months, the use of fixation sutures alone versus tacks (odds ratio 14.1) predicted ideal outcome.

CONCLUSIONS

Ideal outcomes are dependent on both patient-specific and operative factors. The durable, ideal outcome in umbilical hernia repair is most likely in an older, asymptomatic patient who undergoes mesh fixation with permanent suture.

摘要

背景

生活质量已成为疝修补术改善的重要关注点。

方法

查询国际疝补片注册库。卡罗来纳舒适度量表在术后1个月、6个月和每年随访时对生活质量进行量化。所有类别得分均为0（完全无症状）且无复发定义为理想结果。

结果

分析包括363例脐疝修补术；18.7%为腹腔镜手术。人口统计学特征包括年龄51.5±13.8岁，24.5%为女性，平均体重指数为30.63±5.9kg/m²。平均缺损大小为4.3±3.1cm²。平均随访时间为18.2个月。术前无症状/症状轻微在所有时间点均是理想结果的预测因素，年龄增加在6个月和1年时是预测因素。在6个月时，单纯使用固定缝线与钉合器（比值比14.1）可预测理想结果。