Natarajan S, Meenaa S, Thimmaiah K A
Coimbatore Medical College and Hospital, Coimbatore, Tamil Nadu India.
Site-56, Peon Colony, Paadasalai Street, Echanaari, Coimbatore, 641001 Tamil Nadu India.
Indian J Surg. 2017 Apr;79(2):96-100. doi: 10.1007/s12262-015-1430-5. Epub 2016 Jan 21.
Incisional hernia remains a very common postoperative complication. These are encountered with an incidence of up to 20 % following laparotomy. These hernias enlarge over time, making the repair difficult, and serious complications like bowel obstruction, strangulation and enterocutaneous fistula can occur. Hence, elective repair is indicated to avoid these complications. Implantation of a prosthetic mesh is nowadays considered as the standard treatment due to low hernia recurrence. The most common mesh repair techniques used are the onlay repair, sublay repair and laparoscopic intraperitoneal onlay mesh (IPOM). However, it is still not clear which technique among the three is superior. A study consisting of 30 patients who underwent incisional hernia repair by onlay, laparoscopic and preperitoneal mesh repair with abdominoplasty was conducted in the Coimbatore Medical College and Hospital. Of the three groups, the preperitoneal repair with abdominoplasty was found to have better patient compliance and satisfaction with regard to occurrence of complications and appearance of the abdominal wall without laxity in a single sitting.
切口疝仍然是一种非常常见的术后并发症。剖腹手术后其发生率高达20%。这些疝会随着时间的推移而增大，导致修复困难，还可能发生诸如肠梗阻、绞窄和肠皮肤瘘等严重并发症。因此，建议进行择期修复以避免这些并发症。由于疝复发率低，如今植入人工补片被视为标准治疗方法。最常用的补片修复技术是覆盖修补、衬里修补和腹腔镜腹腔内覆盖补片修补术（IPOM）。然而，这三种技术中哪种更优越仍不明确。哥印拜陀医学院和医院开展了一项研究，该研究纳入了30例分别接受覆盖修补、腹腔镜修补和腹膜前补片修补联合腹壁成形术的切口疝修复患者。在这三组中，腹膜前修补联合腹壁成形术在并发症发生情况以及腹壁外观方面具有更好的患者依从性和满意度，且一次性修复后无腹壁松弛。
