Pajtak Alen, Stare Ranko, Biskup Ivica, Lukic Anita, Skorjanec Sandra, Hrzenjak Krunoslav
Department of Surgery, Varazdin General Hospital, Varazdin, Croatia.
Department of Surgery, Varazdin General Hospital, Varazdin, Croatia.
Asian J Surg. 2017 Jul;40(4):278-284. doi: 10.1016/j.asjsur.2016.02.001. Epub 2016 May 18.
BACKGROUND/OBJECTIVE: Incisional hernias (IHs) are a major problem following abdominal surgery. In an effort to resolve large IHs adequately, we herein present our own modified "open intraperitoneal mesh" technique, termed the Garestin technique.
We analyzed early postoperative complications (EPCs; wound infection, hematoma, and seroma) and late postoperative complications (recurrence) in 124 patients operated for IHs and recurrent IHs (RIHs) using our new technique. Our technique involved repairing hernias by preserving the hernia sac, which was later used to conceal the mesh that replaced the abdominal wall defect, thus dividing the mesh from subcutaneous tissue.
We operated 66 patients with IH and 58 patients with RIH. In the 4-week postoperative follow-up, 29 patients had EPC; 9 of them had wound infections that healed upon antibiotic therapy, without the need for any surgical procedure. Of the 10 patients with recurrent herniation in the long-term follow-up, 6 previously had EPC. Recurrences occurred 4-25 months after the operation.
Our method is reliable and safe for large ventral hernia disposal, but the final conclusion requires a larger number of patients and a longer follow-up period.
背景/目的:切口疝是腹部手术后的一个主要问题。为了充分解决大型切口疝问题,我们在此介绍我们自己改良的“开放腹腔内补片”技术,即加雷斯汀技术。
我们分析了124例接受切口疝和复发性切口疝(RIH)手术的患者使用我们的新技术后的早期术后并发症(EPC;伤口感染、血肿和血清肿)和晚期术后并发症(复发)。我们的技术包括通过保留疝囊来修复疝,随后用疝囊来隐藏替代腹壁缺损的补片,从而将补片与皮下组织隔开。
我们为66例切口疝患者和58例复发性切口疝患者进行了手术。在术后4周的随访中,29例患者出现早期术后并发症;其中9例伤口感染经抗生素治疗后愈合,无需任何外科手术。在长期随访中出现复发性疝的10例患者中,6例之前有早期术后并发症。复发发生在术后4 - 25个月。
我们的方法对于大型腹疝的处理是可靠且安全的,但最终结论需要更多患者和更长的随访期。