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脐疝修补术的长期随访结果

Long-term follow-up results of umbilical hernia repair.

作者信息

Venclauskas Linas, Jokubauskas Mantas, Zilinskas Justas, Zviniene Kristina, Kiudelis Mindaugas

机构信息

Department of Surgery, Lithuanian University of Health Sciences, Kaunas, Lithuania.

Department of Radiology, Lithuanian University of Health Sciences, Kaunas, Lithuania.

出版信息

Wideochir Inne Tech Maloinwazyjne. 2017 Dec;12(4):350-356. doi: 10.5114/wiitm.2017.70327. Epub 2017 Sep 26.

Abstract

INTRODUCTION

Multiple suture techniques and various mesh repairs are used in open or laparoscopic umbilical hernia (UH) surgery.

AIM

To compare long-term follow-up results of UH repair in different hernia surgery groups and to identify risk factors for UH recurrence.

MATERIAL AND METHODS

A retrospective analysis of 216 patients who underwent elective surgery for UH during a 10-year period was performed. The patients were divided into three groups according to surgery technique (suture, mesh and laparoscopic repair). Early and long-term follow-up results including hospital stay, postoperative general and wound complications, recurrence rate and postoperative patient complaints were reviewed. Risk factors for recurrence were also analyzed.

RESULTS

One hundred and forty-six patients were operated on using suture repair, 52 using open mesh and 18 using laparoscopic repair technique. 77.8% of patients underwent long-term follow-up. The postoperative wound complication rate and long-term postoperative complaints were significantly higher in the open mesh repair group. The overall hernia recurrence rate was 13.1%. Only 2 (1.7%) patients with small hernias (< 2 cm) had a recurrence in the suture repair group. Logistic regression analysis showed that body mass index (BMI) > 30 kg/m, diabetes and wound infection were independent risk factors for umbilical hernia recurrence.

CONCLUSIONS

The overall umbilical hernia recurrence rate was 13.1%. Body mass index > 30 kg/m, diabetes and wound infection were independent risk factors for UH recurrence. According to our study results, laparoscopic medium and large umbilical hernia repair has slight advantages over open mesh repair concerning early postoperative complications, long-term postoperative pain and recurrence.

摘要

引言

开放或腹腔镜脐疝(UH)手术中使用了多种缝合技术和不同的补片修补方法。

目的

比较不同疝手术组UH修补的长期随访结果,并确定UH复发的危险因素。

材料与方法

对10年间接受择期UH手术的216例患者进行回顾性分析。根据手术技术(缝合、补片和腹腔镜修补)将患者分为三组。回顾了早期和长期随访结果,包括住院时间、术后全身及伤口并发症、复发率和术后患者主诉。还分析了复发的危险因素。

结果

146例患者采用缝合修补,52例采用开放补片修补,18例采用腹腔镜修补技术。77.8%的患者进行了长期随访。开放补片修补组术后伤口并发症发生率和术后长期主诉明显更高。总体疝复发率为13.1%。缝合修补组中只有2例(1.7%)小疝(<2 cm)患者复发。Logistic回归分析显示,体重指数(BMI)>30 kg/m²、糖尿病和伤口感染是脐疝复发的独立危险因素。

结论

总体脐疝复发率为13.1%。体重指数>30 kg/m²、糖尿病和伤口感染是UH复发的独立危险因素。根据我们的研究结果,在术后早期并发症、术后长期疼痛和复发方面,腹腔镜中大型脐疝修补术比开放补片修补术略有优势。

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