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使用ParietexTM复合补片对重度肥胖和非重度肥胖患者进行腹腔镜腹疝修补术的长期临床经验:一项单中心队列研究

Long-term clinical experience with laparoscopic ventral hernia repair using a ParietexTM composite mesh in severely obese and non-severe obese patients: a single center cohort study.

作者信息

de Vries Hilbert S, Smeeing Diederik, Lourens Harm, Kruyt Philip M, Mollen Roland M H G

机构信息

Department of Surgery, Hospital Gelderse Vallei, Ede, The Netherlands.

Department of Anaesthesiology, Hospital Gelderse Vallei, Ede, The Netherlands.

出版信息

Minim Invasive Ther Allied Technol. 2019 Oct;28(5):304-308. doi: 10.1080/13645706.2018.1521431. Epub 2018 Oct 11.

Abstract

The treatment of incisional and ventral hernias is associated with significant complications and recurrences, especially in severely obese patients. Recent studies have shown a reduced rate of surgical site infections and length of hospital stay in severely obese patients undergoing a laparoscopic ventral hernia repair. This study aims to describe the clinical experience in terms of efficacy and safety with laparoscopic ventral hernia repair using the ParietexTM Composite mesh (Covidien Sofradim Production, Trevoux, France) in severely obese patients (body mass index ≥35) compared with non-severe obese patients in a seven-year single-center cohort. All patients with a primary ventral or incisional hernia admitted to our hospital from 2006 until December 2012 who underwent a laparoscopic repair with the Parietex Composite mesh were included in this study. Pain scores using a numeric rating were collected prospectively 24-48 hours postoperatively. Patient data were retrospectively collected. A total number of 210 patients were included; 173 with a BMI <35 and 37 with a BMI ≥35. Mean follow-up was 31 months. No statistically significant differences were found with regard to operation time, hospital stay, use of analgesics and postoperative complications. The long-term follow up recurrence rate in non-severely obese patients was 13% compared to 16% in severely obese patients ( = .60). Laparoscopic ventral and incisional hernia repair using the Parietex Composite mesh is feasible and safe in severely obese patients compared to non-severely obese patients.

摘要

切口疝和腹疝的治疗会引发严重并发症及复发问题,在重度肥胖患者中尤为如此。近期研究表明,接受腹腔镜下腹疝修补术的重度肥胖患者手术部位感染率降低,住院时间缩短。本研究旨在描述在一个为期七年的单中心队列中,使用ParietexTM复合补片(柯惠索法迪姆公司生产,法国特雷武)对重度肥胖患者(体重指数≥35)进行腹腔镜下腹疝修补术的疗效和安全性方面的临床经验,并与非重度肥胖患者进行比较。本研究纳入了2006年至2012年12月期间在我院接受腹腔镜下使用Parietex复合补片修补原发性腹疝或切口疝的所有患者。术后24 - 48小时前瞻性收集采用数字评分法的疼痛评分。回顾性收集患者数据。共纳入210例患者,其中173例体重指数<35,37例体重指数≥35。平均随访时间为31个月。在手术时间、住院时间、镇痛药使用及术后并发症方面未发现统计学显著差异。非重度肥胖患者的长期随访复发率为13%,重度肥胖患者为16%(P = 0.60)。与非重度肥胖患者相比,使用Parietex复合补片对重度肥胖患者进行腹腔镜下腹疝和切口疝修补术是可行且安全的。

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