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胃旁路手术后患者的一期覆盖式疝修补术联合腹壁成形术

One stage onlay hernia repair with abdominoplasty in patients following gastric bypass surgery.

作者信息

Iljin Aleksandra, Antoszewski Bogusław, Zieliński Tomasz, Skulimowski Aleksander, Szymański Dariusz, Strzelczyk Janusz

机构信息

Uniwersytet Medyczny w Łodzi Klinika Chirurgii Plastycznej, Rekonstrukcyjnej i Estetycznej.

Uniwersytet Medyczny w Łodzi Klinika Chirurgii Ogólnej i Transplantacyjnej.

出版信息

Pol Przegl Chir. 2018 Oct 19;90(6):1-7. doi: 10.5604/01.3001.0012.7027.

DOI:10.5604/01.3001.0012.7027
PMID:30652686
Abstract

PURPOSE

  1. Evaluation of results after one-time incisional hernia repair (IHR) modo on-lay and abdominoplasty (Ab-pl) in patients after loss of weight following previous Roux-en-Y Gastric Bypass – RYGB. 2. Analysis of differences in quality of life (QL) changes in bariatric patients before RYGB, as well as before and after abdominal contouring operation.tion.

MATERIAL AND METHODS

Clinical analysis involved 20 patients with abdominal disfigurement (following RYGB, and massive weight loss) who underwent one-time IHR using on-lay method together with abdominoplasty. We estimated postoperative results, as well as changes in QL, before RYGB and before and after abdominal contouring procedure (based on DAS 24 and SF-36 scales) in comparison with stage before surgeries.

RESULTS

Complications - abnormal wound healing (infection, local necrosis) and pneumonia were found in two persons, seroma in two cases, whereas dysesthesia in four patients. We confirmed QL improvement in all aspects after each stage of treatment.

CONCLUSIONS

  1. One-stage on-lay hernia repair and abdominoplasty is a safe method improving the functioning of patients. 2. All stages of bariatric treatment resulted in gradual improvement of the quality of life. 3. High BMI in patients before onlay incisional hernia repair with abdominoplasty increases the risk of complications, which is connected with longer hospital stay.
摘要

目的

  1. 评估既往接受Roux-en-Y胃旁路术(RYGB)后体重减轻的患者采用一次性切口疝修补术(IHR)外置法和腹壁成形术(Ab-pl)后的效果。2. 分析肥胖症患者在RYGB之前以及腹部整形手术前后生活质量(QL)变化的差异。

材料与方法

临床分析纳入20例有腹部畸形(RYGB后且体重大幅减轻)的患者,他们采用外置法一次性进行IHR并同时接受腹壁成形术。我们评估了术后结果以及与手术前阶段相比,RYGB之前以及腹部整形手术前后的QL变化(基于DAS 24和SF-36量表)。

结果

并发症方面,2人出现伤口愈合异常(感染、局部坏死)和肺炎,2例出现血清肿,4例患者出现感觉异常。我们证实了在每个治疗阶段后各个方面的QL均有改善。

结论

  1. 一期外置疝修补术和腹壁成形术是改善患者功能的安全方法。2. 肥胖症治疗的所有阶段均导致生活质量逐渐改善。3. 接受外置切口疝修补术并腹壁成形术的患者术前高BMI会增加并发症风险,这与更长的住院时间有关。

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