Mommers E H H, Leenders B J M, Leclercq W K G, de Vries Reilingh T S, Charbon J A
Department of Surgery, Elkerliek Hospital, Helmond, The Netherlands.
Department of Surgery, Maastricht University Medical Centre, Maastricht, The Netherlands.
Hernia. 2017 Aug;21(4):591-600. doi: 10.1007/s10029-017-1602-2. Epub 2017 Apr 13.
To evaluate the short- and long-term results after a modified Chevrel technique for midline incisional hernia repair, regarding surgical technique, hospital stay, wound complications, recurrence rate, and postoperative quality of life. These results will be compared to the literature derived reference values regarding the original and modified Chevrel techniques.
In this large retrospective, single surgeon, single centre cohort all modified Chevrel hernia repairs between 2000 and 2012 were identified. Results were obtained by reviewing patients' medical charts. Postoperative quality of life was measured using the Carolina Comfort Scale. A multi-database literature search was conducted to compare the results of our series to the literature based reference values.
One hundred and fifty-five patients (84 male, 71 female) were included. Eighty patients (52%) had a large incisional hernia (width ≥ 10 cm) according the definition of the European Hernia Society. Fourteen patients (9%) underwent a concomitant procedure. Median length-of-stay was 5 days. Within 30 days postoperative 36 patients (23.2%) had 39 postoperative complications of which 30 were mild (CDC I-II), and nine severe (CDC III-IV). Thirty-one surgical site occurrences were observed in thirty patients (19.4%) of which the majority were seroma (16 patients 10.3%). There was no hernia-related mortality during follow-up. Recurrence rate was 1.8% after a median follow-up of 52 months (12-128 months). Postoperative quality of life was rated excellent.
The modified Chevrel technique for midline ventral hernias results in a moderate complication rate, low recurrence rate and high rated postoperative quality of life.
评估改良Chevrel技术用于中线切口疝修补术后的短期和长期效果，内容涉及手术技术、住院时间、伤口并发症、复发率和术后生活质量。将这些结果与文献中关于原始Chevrel技术和改良Chevrel技术的参考值进行比较。
在这项大型回顾性研究中，纳入了2000年至2012年间由单一外科医生在单一中心进行的所有改良Chevrel疝修补术病例。通过查阅患者病历获得结果。使用卡罗莱纳舒适度量表测量术后生活质量。进行多数据库文献检索，以将本系列结果与基于文献的参考值进行比较。
纳入155例患者（84例男性，71例女性）。根据欧洲疝学会的定义，80例患者（52%）患有大型切口疝（宽度≥10 cm）。14例患者（9%）接受了同期手术。中位住院时间为5天。术后30天内，36例患者（23.2%）出现39例术后并发症，其中30例为轻度（美国疾病控制与预防中心I-II级），9例为重度（美国疾病控制与预防中心III-IV级）。30例患者（19.4%）出现31例手术部位事件，其中大多数为血清肿（16例患者，10.3%）。随访期间无疝相关死亡。中位随访52个月（12 - 128个月）后复发率为1.8%。术后生活质量评定为优秀。
改良Chevrel技术用于中线腹疝修补术并发症发生率中等、复发率低且术后生活质量评分高。
