定义巨大腹疝修补术的手术结果和生活质量：一项国际多中心前瞻性研究。
Defining surgical outcomes and quality of life in massive ventral hernia repair: an international multicenter prospective study.
作者信息
Ross Samuel W, Wormer Blair A, Kim Mimi, Oommen Bindhu, Bradley Joel F, Lincourt Amy E, Augenstein Vedra A, Heniford B Todd
机构信息
Division of Gastrointestinal and Minimally Invasive Surgery, Department of Surgery, Carolinas Medical Center, Carolinas Hernia Center, 1025 Morehead Medical Drive, Suite 300, Charlotte, NC 28204, USA.
Division of Gastrointestinal and Minimally Invasive Surgery, Department of Surgery, Carolinas Medical Center, Carolinas Hernia Center, 1025 Morehead Medical Drive, Suite 300, Charlotte, NC 28204, USA.
出版信息
Am J Surg. 2015 Nov;210(5):801-13. doi: 10.1016/j.amjsurg.2015.06.020. Epub 2015 Aug 20.
BACKGROUND
Our goal was to set criteria for massive ventral hernia and to compare surgical outcomes and quality of life after ventral hernia repair (VHR).
METHODS
The International Hernia Mesh Registry was queried for patients undergoing VHR from 2007 to 2013. Defect was categorized as massive if the width or length was greater than 15 cm or area greater than 150 cm(2). Massive VHR was compared to regular VHR.
RESULTS
A total of 878 patients underwent VHR: 436 open, 442 laparoscopic with 13 deaths (1.5%) and 45 hernia recurrences (5.1%). Of those, 158 patients (18%) met criteria for massive VHR. Massive VHR patients had longer length of stay (LOS) and operative time and more hematomas, wound infections, wound complications, and pneumonias (P < .05). On multivariate analysis, LOS was longer, and early postoperative pain and activity limitation were greater in massive VHRs (P < .01). Massive VHR in the laparoscopic approach resulted in greater long-term mesh sensation (P < .01).
CONCLUSIONS
VHR in massive hernias have increased rates of complications and longer LOS.
背景
我们的目标是制定巨大腹疝的标准，并比较腹疝修补术（VHR）后的手术结果和生活质量。
方法
查询国际疝修补网登记处2007年至2013年接受VHR的患者。如果缺损宽度或长度大于15厘米或面积大于150平方厘米，则将其分类为巨大缺损。将巨大VHR与常规VHR进行比较。
结果
共有878例患者接受了VHR：436例开放手术，442例腹腔镜手术，13例死亡（1.5%），45例疝复发（5.1%）。其中，158例患者（18%）符合巨大VHR标准。巨大VHR患者的住院时间（LOS）和手术时间更长，血肿、伤口感染、伤口并发症和肺炎更多（P < .05）。多因素分析显示，巨大VHR的LOS更长，术后早期疼痛和活动受限更严重（P < .01）。腹腔镜手术的巨大VHR导致更大的长期网片不适感（P < .01）。
结论
巨大疝的VHR并发症发生率增加，LOS更长。
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