Liang Mike K, Li Linda T, Nguyen Mylan T, Berger Rachel L, Hicks Stephanie C, Kao Lillian S
University of Texas Health Science Center, Houston, Texas, USA.
Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX, USA.
Am J Surg. 2014 Oct;208(4):670-6. doi: 10.1016/j.amjsurg.2013.10.024. Epub 2014 Jan 17.
This study sought to identify the incidence, indications, and predictors of abdominal reoperation and mesh explantation following open ventral hernia repair with mesh (OVHR).
A retrospective cohort study of all patients at a single institution who underwent an OVHR from 2000 to 2010 was performed. Patients who required subsequent abdominal reoperation or mesh explantation were compared with those who did not. Reasons for reoperation were recorded. The 2 groups were compared using univariate and multivariate analysis (MVA).
A total of 407 patients were followed for a median (range) of 57 (1 to 143) months. Subsequent abdominal reoperation was required in 69 (17%) patients. The most common reasons for reoperation were recurrence and surgical site infection. Only the number of prior abdominal surgeries was associated with abdominal reoperation on MVA. Twenty-eight patients (6.9%) underwent subsequent mesh explantation. Only the Ventral Hernia Working Group grade was associated with mesh explantation on MVA.
Abdominal reoperation and mesh explantation following OVHR are common. Overwhelmingly, surgical complications are themost common causes for reoperation and mesh explantation.
本研究旨在确定开放腹疝补片修补术(OVHR)后腹部再次手术及补片取出术的发生率、适应证及预测因素。
对一家机构2000年至2010年期间接受OVHR的所有患者进行回顾性队列研究。将需要后续腹部再次手术或补片取出术的患者与未进行这些操作的患者进行比较。记录再次手术的原因。采用单因素和多因素分析(MVA)对两组进行比较。
共对407例患者进行了中位(范围)57(1至143)个月的随访。69例(17%)患者需要进行后续腹部再次手术。再次手术最常见的原因是复发和手术部位感染。多因素分析显示,只有既往腹部手术的次数与腹部再次手术相关。28例(6.9%)患者接受了后续补片取出术。多因素分析显示,只有腹疝工作组分级与补片取出术相关。
OVHR后腹部再次手术及补片取出术很常见。手术并发症是再次手术和补片取出术最常见的原因。