Digestive Disease Center, Bispebjerg Hospital, University of Copenhagen, Copenhagen, Denmark.
Digestive Disease Center, Bispebjerg Hospital, University of Copenhagen, Copenhagen, Denmark.
J Surg Res. 2019 Dec;244:160-165. doi: 10.1016/j.jss.2019.06.016. Epub 2019 Jul 8.
Patients with an incisional hernia often wait a significant period of time from the first referral to hernia surgery because of waiting lists, watchful waiting, or the need for preoperative optimization. It is unknown if hernia dimensions or patient-reported symptoms increase during this period. The aim of the study was to examine if incisional hernias increase in size during the time from initial assessment to surgical repair.
A prospective controlled trial was performed on patients referred to a regional hernia center for repair of an incisional hernia with a transverse fascial defect of >7 cm. All patients underwent computed tomography scans and answered the Hernia-Related Quality of Life Score questionnaire and International Physical Activity Questionnaire at first assessment and again 30 ± 2 wk later or immediately before hernia repair. Changes in fascial defect sizes and hernia sac volume were assessed along with the patient-reported outcomes.
A total of 35 patients were included. The median fascial defect area increased from 117.3 cm (interquartile range 46.5-181.2) to 150.4 cm (62.5-199.0), P < 0.001, and the median hernia sac volume increased from 5.11 L (2.28-8.09) to 6.25 L (3.03-10.38), P < 0.001. There were no significant changes in the patient-reported outcomes.
Incisional hernias expand during the period from the first assessment to actual hernia repair.
由于等待名单、观察等待或术前优化的需要，患有切口疝的患者通常需要在第一次转诊到疝手术之间等待相当长的时间。在此期间，疝的尺寸或患者报告的症状是否增加尚不清楚。本研究的目的是检查从最初评估到手术修复期间切口疝的大小是否增加。
对因>7cm 横筋膜缺损而被转诊到区域疝中心修复切口疝的患者进行前瞻性对照试验。所有患者均行计算机断层扫描，并在首次评估时以及 30±2wk 后（或在疝修复前）再次回答疝相关生活质量评分问卷和国际体力活动问卷。评估筋膜缺损大小和疝囊体积的变化以及患者报告的结果。
共纳入 35 例患者。筋膜缺损面积中位数从 117.3cm（四分位距 46.5-181.2）增加到 150.4cm（62.5-199.0），P<0.001，疝囊体积中位数从 5.11L（2.28-8.09）增加到 6.25L（3.03-10.38），P<0.001。患者报告的结果没有显著变化。
从首次评估到实际疝修复期间，切口疝会扩大。
