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生物假体在移植患者中的有效性和多功能性。

Effectiveness and versatility of biological prosthesis in transplanted patients.

作者信息

Vennarecci Giovanni, Mascianà Gianluca, De Werra Edoardo, Sandri Giovanni Battista Levi, Ferraro Daniele, Burocchi Mirco, Tortorelli Giovanni, Guglielmo Nicola, Ettorre Giuseppe Maria

机构信息

Giovanni Vennarecci, Gianluca Mascianà, Edoardo De Werra, Giovanni Battista Levi Sandri, Daniele Ferraro, Mirco Burocchi, Giovanni Tortorelli, Nicola Guglielmo, Giuseppe Maria Ettorre, Division of Surgical Oncology and Liver Transplantation, San Camillo Hospital, POIT San Camillo-INMI Lazzaro Spallanzani, 00149 Rome, Italy.

出版信息

World J Transplant. 2017 Feb 24;7(1):43-48. doi: 10.5500/wjt.v7.i1.43.

Abstract

AIM

To emphasize the effectiveness and versatility of prosthesis, and good tolerance by patients with incisional hernia (IH).

METHODS

From December 2001 to February 2016, 270 liver transplantations were performed at San Camillo Hospital. IH occurred in 78 patients (28.8%). IH usually appeared early within the first year post-orthotopic liver transplantation. In the first era, fascial defect was repaired by primary closure for defects smaller than 2.5 cm or with synthetic mesh for greater defects. Recently, we started using biological mesh (Permacol™, Covidien). We present a series of five transplanted patients submitted to surgery for abdominal wall defect correction repaired with biological mesh (Permacol™, Covidien).

RESULTS

In our cases, the use of biological prosthesis (Permacol™, Covidien) have proven to be effective and versatile in repairing hernia defects of different kinds; patients did not suffer infections of the prosthesis and no recurrence was observed. Furthermore, the prosthesis remains intact even in the years after surgery.

CONCLUSION

The cases that we presented show that the use of biological mesh (Permacol™, Covidien) in transplanted patients may be safe and effective, being careful in the management of perioperative immunosuppression and renal and graft function, although the cost of the product itself has been the main limiting factor and there is need for prospective studies for further evaluations.

摘要

目的

强调假体的有效性和多功能性,以及切口疝(IH)患者对其良好的耐受性。

方法

2001年12月至2016年2月,圣卡米洛医院共进行了270例肝移植手术。78例患者(28.8%)发生了切口疝。切口疝通常在原位肝移植后的第一年内早期出现。在第一个阶段,对于小于2.5 cm的筋膜缺损采用一期缝合修复,对于较大的缺损则使用合成网片修复。最近,我们开始使用生物网片(Permacol™,柯惠医疗)。我们展示了一系列五例接受手术以使用生物网片(Permacol™,柯惠医疗)修复腹壁缺损的移植患者。

结果

在我们的病例中,使用生物假体(Permacol™,柯惠医疗)已被证明在修复各种疝缺损方面是有效且多功能的;患者未发生假体感染,也未观察到复发。此外,即使在手术后数年,假体仍保持完整。

结论

我们展示的病例表明,在移植患者中使用生物网片(Permacol™,柯惠医疗)可能是安全有效的,尽管产品本身的成本一直是主要限制因素,且需要进行前瞻性研究以作进一步评估,但在围手术期免疫抑制以及肾脏和移植物功能管理方面需谨慎。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/855f/5324027/eaf5eb4af656/WJT-7-43-g001.jpg

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