Winder J S, Majumder A, Fayezizadeh M, Novitsky Y W, Pauli E M
Department of General Surgery, Penn State Milton S. Hershey Medical Center, 500 University Drive, H149, Hershey, PA, 17033, USA.
Cleveland Comprehensive Hernia Center, University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, OH, USA.
Hernia. 2018 Apr;22(2):303-309. doi: 10.1007/s10029-018-1732-1. Epub 2018 Jan 18.
A minority of patients undergoing posterior component separation (PCS) have abdominal wall defects that preclude complete reconstruction of the visceral sac with native tissue. The use of absorbable mesh bridges (AMB) to span such defects has not been established. We hypothesized that AMB use during posterior sheath closure of PCS is safe and provides favorable outcomes.
We performed a retrospective review of consecutive patients undergoing PCS with AMB at two hernia centers. Main outcome measures included demographics, comorbidities, and post-operative complications.
36 patients were identified. Post-operative wound complications included five surgical site infections. At a median of 27 months, there were five recurrent hernias (13.9%), 2 of which were parastomal, but no episodes of intestinal obstruction/fistula.
Utilization of AMB for large posterior layer deficits results in acceptable rates of perioperative wound morbidity, effective PCS repairs, and does not increase intestinal morbidity or fistula formation.
少数接受后入路成分分离术（PCS）的患者存在腹壁缺损，无法用自体组织完全重建内脏囊。使用可吸收网片桥接（AMB）来跨越此类缺损尚未得到证实。我们假设在PCS后鞘关闭过程中使用AMB是安全的，并能提供良好的结果。
我们对两个疝气中心连续接受带AMB的PCS治疗的患者进行了回顾性研究。主要观察指标包括人口统计学、合并症和术后并发症。
共纳入36例患者。术后伤口并发症包括5例手术部位感染。中位随访27个月时，有5例复发性疝（13.9%），其中2例为造口旁疝，但无肠梗阻/肠瘘发生。
对于较大的后层缺损，使用AMB导致围手术期伤口发病率可接受，PCS修复有效，且不会增加肠道发病率或瘘管形成。
