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[生物补片在会阴疝患者盆底重建中的应用]

[Application of biological mesh for reconstruction of pelvic floor in patients with perineal hernia].

作者信息

Fei Yang, Li Jiye, Tian Wen

机构信息

Department of General Surgery, General Hospital of Chinese PLA, Beijing, P.R. China.

出版信息

Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2014 Oct;28(10):1270-2.

Abstract

OBJECTIVE

To investigate the effectiveness of repair procedure using biological mesh with Onlay-Reinforce technique in patients with perineal hernia.

METHODS

Between January 2005 and December 2012, 9 patients with perineal hernia after laparoscopic abdominoperineal resection for rectal cancer (Miles operation) were treated. There were 3 males and 6 females with a mean age of 70 years (range, 61-78 years). The disease duration was 1-9 months (mean, 4.5 months). The most beginning symptom was distending pain in perineal region, and then reducible mass was found without bowel incarceration. All patients underwent hernia repair using biological mesh with Onlay-Reinforce technique through original perineal incision.

RESULTS

The hernial size was 9.8-20.5 cm2 (mean, 16.0 cm2); the size of biological mesh was 58-80 cm2 (mean, 70.2 cm2); and the intraoperative blood loss was 10-80 mL (mean, 50.5 mL). All of the patients underwent repair operation successfully. The operation time was 45-90 minutes (mean, 60.6 minutes); and the hospitalization time was 4-7 days (mean, 5.9 days). One patient had urine retention, which was relieved after 7 days indwelling catheter. All the wounds healed by first intention without infection. The patients were followed up 14.5-60.7 months (mean, 37.8 months). No chronic pain, obvious foreign body sensation, or hernia recurrence developed.

CONCLUSION

Use of biological mesh with Onlay-Reinforce technique for the repair ofperineal hernia after Miles operation is safe and effective.

摘要

目的

探讨生物补片外置加固技术修复会阴疝的疗效。

方法

2005年1月至2012年12月,对9例直肠癌腹腔镜腹会阴联合切除术(Miles手术)后发生会阴疝的患者进行治疗。其中男性3例,女性6例,平均年龄70岁(范围61 - 78岁)。病程1 - 9个月(平均4.5个月)。最初症状为会阴区胀痛,随后发现可复性包块,无肠管嵌顿。所有患者均通过原会阴切口采用生物补片外置加固技术进行疝修补术。

结果

疝大小为9.8 - 20.5 cm²(平均16.0 cm²);生物补片大小为58 - 80 cm²(平均70.2 cm²);术中出血量为10 - 80 mL(平均50.5 mL)。所有患者均成功完成修补手术。手术时间为45 - 90分钟(平均60.6分钟);住院时间为4 - 7天(平均5.9天)。1例患者出现尿潴留,留置导尿管7天后缓解。所有伤口均一期愈合,无感染发生。患者随访14.5 - 60.7个月(平均37.8个月)。未出现慢性疼痛、明显异物感或疝复发。

结论

Miles手术后采用生物补片外置加固技术修复会阴疝安全有效。

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