de Mesquita Gustavo Heluani Antunes, Iuamoto Leandro Ryuchi, Suguita Fabio Yuji, Essu Felipe Futema, Oliveira Lucas Torres, Torsani Matheus Belloni, Meyer Alberto, Andraus Wellington
Department of Gastroenterology, University Of São Paulo Medical School, Av. Dr. Arnaldo, 455 - Cerqueira César, São Paulo, SP, 01246-903, Brazil.
Abdominal Wall Repair Center, Samaritano Hospital, São Paulo, Brazil.
BMC Surg. 2017 May 5;17(1):51. doi: 10.1186/s12893-017-0249-3.
Subxiphoid incisional hernia occurs as a complication following median sternotomy and are difficult to repair. We present recent data of a standardized technique for correction of subxiphoid incisional hernias, and discuss possible anatomical and surgical factors related to recurrence of the hernia.
A retrospective study with medical records analysis of patients submitted to surgical correction of subxiphoid incisional hernias through standardized treatment between July 2014 and September 2016. All procedures were carried out using the same standardized technique, surgical materials (threads and meshes) and pre- and post-operative care.
All of the surgical procedures carried out were elective. The hernia defect varied between 5 cm and 16 cm (mean of 7.4 cm); the procedure lasted between 32 and 75 min; the mean time of hospital stay was 2.2 days (range from 1 to 5 days). In five patients the correction of subxiphoid incisional hernia was carried out concurrently with another procedure. No death occurred as a result of the operations. Five patients had minor postoperative complications. Follow up time was between 7 and 33 months, with a recurrence rate of 0% at the time of writing.
Despite the limitations of a short follow up period, the surgical technique described presented low rates of early recurrence by closing the hernia defect, using relaxing incisions in the musculature and aponeurosis and surgical mesh.
剑突下切口疝是正中开胸术后的一种并发症,难以修复。我们展示了矫正剑突下切口疝的标准化技术的最新数据,并讨论了与疝复发相关的可能的解剖学和手术因素。
一项回顾性研究,对2014年7月至2016年9月间接受剑突下切口疝手术矫正的患者的病历进行分析。所有手术均采用相同的标准化技术、手术材料(缝线和补片)以及术前和术后护理。
所有手术均为择期手术。疝缺损在5厘米至16厘米之间(平均7.4厘米);手术持续时间在32至75分钟之间;平均住院时间为2.2天(1至5天)。5例患者在矫正剑突下切口疝的同时还进行了另一项手术。手术未导致死亡。5例患者出现轻微术后并发症。随访时间为7至33个月,撰写本文时复发率为0%。
尽管随访期较短存在局限性,但所描述的手术技术通过闭合疝缺损、在肌肉组织和腱膜中使用松弛切口以及手术补片,早期复发率较低。