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在门诊社区医院环境中使用cPTFE人工补片进行腹腔镜腹壁重建的可行性:一项前瞻性多中心病例系列研究

Feasibility of laparoscopic abdominal wall reconstruction in an outpatient community-hospital setting using cPTFE prosthetic mesh: a prospective, multicenter case series.

作者信息

Unruh Terry, Boachie Joseph Adjei, Smith-Singares Eduardo

机构信息

1 Department of Surgery, Medical Center Hospital & Odessa Regional Medical Center, Odessa, TX, USA.

2 College of Medicine, University of Illinois at Chicago, Chicago, IL, USA.

出版信息

J Int Med Res. 2016 Dec;44(6):1506-1513. doi: 10.1177/0300060516667321. Epub 2016 Nov 10.

Abstract

Objective This study investigated the use of prosthetic condensed polytetrafluoroethylene (cPTFE) for laparoscopic ventral hernia repair (LVHR) in an outpatient community-hospital setting. Methods Patients underwent LVHR with cPTFE at one of three community hospitals. Primary endpoint was hernia recurrence at 1-year postoperatively. Secondary endpoints included pain, surgical site infection, medical/surgical complications, and patient-reported outcomes. Results This study included 65 females and 52 males, aged 46.6 ± 13.2 years (mean ± SD; range 18-84 years). Mean prosthetic size was 413.8 ± 336.11 cm (range 165-936 cm). Mean follow-up was 30 months (range 12-46 months). Hernia recurrence rate was 4.3%. Rate of hospitalization in the first postoperative week was 2.6%. Early and late secondary endpoint complication rates were 24.8% and 27.4%, respectively; pain was the most common complication, followed by seroma (8.5%). Conclusions Outpatient LVHR using cPTFE is feasible in community hospitals. Complication rates were similar to previous reports, and the seroma rate was markedly lower.

摘要

目的 本研究在门诊社区医院环境中调查了人工合成的缩聚聚四氟乙烯(cPTFE)用于腹腔镜腹疝修补术(LVHR)的情况。方法 患者在三家社区医院之一接受了使用cPTFE的LVHR手术。主要终点是术后1年的疝复发情况。次要终点包括疼痛、手术部位感染、医疗/手术并发症以及患者报告的结局。结果 本研究纳入了65名女性和52名男性,年龄为46.6±13.2岁(均值±标准差;范围18 - 84岁)。人工合成材料的平均尺寸为413.8±336.11平方厘米(范围165 - 936平方厘米)。平均随访时间为30个月(范围12 - 46个月)。疝复发率为4.3%。术后第一周的住院率为2.6%。早期和晚期次要终点并发症发生率分别为24.8%和27.4%;疼痛是最常见的并发症,其次是血清肿(8.5%)。结论 在社区医院中,门诊使用cPTFE进行LVHR是可行的。并发症发生率与先前报告相似,且血清肿发生率明显更低。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/32e8/5536773/f178a66ec982/10.1177_0300060516667321-fig1.jpg

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