Saied Abdul, David Jenny, LaBarbera Kim, Katz Steven C, Somasundar Ponnandai
Department of Surgery, Roger Williams Medical Center, Providence, Rhode Island.
J Surg Oncol. 2015 May;111(6):725-8. doi: 10.1002/jso.23869. Epub 2015 Jan 8.
Patients receiving chemotherapy are at increased risk for developing recurrent or post-incisional hernias (PIH). Biological materials are an alternative to synthetic mesh in contaminated fields. The impact of chemotherapy on biomaterial tissue ingrowth and integration has not been well studied.
From 2008 to 2011 patients who underwent PIH repair with biomaterial mesh (Biodesign®) were selected. Patients were divided into two groups: those receiving chemotherapy (CT) and those not receiving chemotherapy (NCT).
Forty-five patients were identified, 28 (62%) in the NCT group and 17 (38%) in the CT group. Median follow up for NCT and CT groups were 27 and 17 months, respectively. A total of 9/45 (20%) surgical site infections (SSI) were diagnosed, with 6/28 (21%) in the NCT and 3/17 (18%) in the CT group (P = 0.53). Seroma formation was seen in 5/28 (18%) of NCT patients and 4/17 (23%) in CT group (P = 0.46). Overall hernia recurrence rate was 22%, and the rates of recurrence were similar among the CT 3/17 (18%) and NCT 7/28 (25%) groups (P = 0.42).
The use of perioperative chemotherapy did not increase the rate of wound complications following PIH repair with biologic mesh in this group of patients.
接受化疗的患者发生复发性或切口后疝(PIH)的风险增加。在污染区域,生物材料可作为合成补片的替代物。化疗对生物材料组织长入和整合的影响尚未得到充分研究。
选取2008年至2011年期间接受生物材料补片(Biodesign®)修复PIH的患者。患者分为两组:接受化疗(CT)的患者和未接受化疗(NCT)的患者。
共确定45例患者,NCT组28例(62%),CT组17例(38%)。NCT组和CT组的中位随访时间分别为27个月和17个月。共诊断出9/45(20%)例手术部位感染(SSI),NCT组6/28(21%),CT组3/17(18%)(P = 0.53)。NCT组5/28(18%)的患者出现血清肿,CT组4/17(23%)(P = 0.46)。总体疝复发率为22%,CT组3/17(18%)和NCT组7/28(25%)的复发率相似(P = 0.42)。
在这组患者中,围手术期化疗的使用并未增加生物补片修复PIH后伤口并发症的发生率。