Chen J-X, Shih P-K
Department of Surgery, China Medical University Hospital, Taichung, Taiwan.
China Medical University, Taichung, Taiwan.
Hernia. 2021 Apr;25(2):331-336. doi: 10.1007/s10029-020-02183-w. Epub 2020 Apr 23.
This study tries to compare three methods in complex abdominal wall reconstruction.
A retrospective review was conducted at a single medical center between December 2008 and May 2019. Forty-seven patients who received abdominal fascia repair were enrolled. The patients were divided into three groups: A [component separation technique (CST)], B (partition technique), and C [extended anterolateral thigh (ALT) flap]. All relevant patient information was collected. Statistical analysis including one-way analysis of variance, Chi-square test, and the receiver operating characteristic curve were used.
There were no significant differences between the group results related to gender, age, BMI, follow-up, diabetes mellitus, tobacco, or short-, and long-term complications. However, there were significant differences in fascia defect size between groups (group A: 7.6 cm vs. group B: 10.76 cm vs. group C: 13.64 cm). The averaged operative time in group C (339.25 mins) was significantly longer than that in group A (145.40 mins) and B (152.37 mins). The hospitalization in group C (24.1 days) was significantly longer than that in group A (8.2 days) and B (10.3 days). The complication thresholds of group A and group B are 9.45 cm and 11.75 cm, respectively.
This study suggests that extended ALT flap provides the largest fascia defect closure, followed orderly by partition technique and CST, but requires longer operative time and hospitalization. There are no significant differences in postoperative complications between three groups. A prospective study with indications based on these findings is suggested.
本研究旨在比较复杂腹壁重建中的三种方法。
于2008年12月至2019年5月在单一医疗中心进行回顾性研究。纳入47例行腹部筋膜修复的患者。患者分为三组：A组[成分分离技术（CST）]、B组（分区技术）和C组[股前外侧（ALT）皮瓣延长术]。收集所有相关患者信息。采用包括单因素方差分析、卡方检验和受试者工作特征曲线在内的统计分析方法。
三组结果在性别、年龄、体重指数、随访、糖尿病、吸烟情况或短期及长期并发症方面无显著差异。然而，三组间筋膜缺损大小存在显著差异（A组：7.6 cm，B组：10.76 cm，C组：13.64 cm）。C组的平均手术时间（339.25分钟）显著长于A组（145.40分钟）和B组（152.37分钟）。C组的住院时间（24.1天）显著长于A组（8.2天）和B组（10.3天）。A组和B组的并发症阈值分别为9.45 cm和11.75 cm。
本研究表明，股前外侧皮瓣延长术可闭合最大的筋膜缺损，其次依次为分区技术和成分分离技术，但手术时间和住院时间较长。三组术后并发症无显著差异。建议基于这些发现进行前瞻性研究。
