Department of General Surgery, Centre Hospitalier Intercommunal de Créteil, 40 Avenue de Verdun, 94000, Créteil, France.
INSERM, UMR_S 1138, Centre de Recherche des Cordeliers, Université Paris Descartes, 75006, Paris, France.
Obes Surg. 2018 Sep;28(9):2949-2955. doi: 10.1007/s11695-018-3366-x.
This study is a review on the management of ventral hernia during bariatric surgery. The main outcomes are the recurrence rate after ventral hernia repair and the incidence of prosthetic infection. Eleven studies were included. Ventral hernias were treated by simple suture (n = 191), synthetic mesh (n = 186), and biological mesh (n = 72). Mean defect size was 18 cm. Recurrence rate was 25.7% in the suture group, 14.3% in the biomesh group, and 1.1% in the synthetic mesh group (p < 0.05). Mesh infection rate was not different between the groups. No significant difference was observed in 30-day reoperation. Concomitant treatment of small hernia defect is feasible and safe during bariatric surgery. Synthetic mesh provides a significantly lower recurrence rate without any increase in 30-day wound morbidity.
本研究是对减重手术中腹疝管理的综述。主要结局是腹疝修补术后的复发率和假体感染的发生率。共纳入 11 项研究。腹疝采用单纯缝合(n=191)、合成网片(n=186)和生物网片(n=72)治疗。平均缺损大小为 18cm。缝合组的复发率为 25.7%,生物网片组为 14.3%,合成网片组为 1.1%(p<0.05)。各组间网片感染率无差异。30 天再次手术率无显著差异。减重手术中同时处理小疝缺损是可行和安全的。合成网片可显著降低复发率,而 30 天伤口并发症发生率无增加。