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双环缝合法(DCST)在巨大切口疝修补术中的应用。

Application of double circular suturing technique (DCST) in repair of giant incision hernias.

作者信息

Song Ying-Han, Huang Wei-Jia, Xie Yan-Yan, Hada Gonish, Zhang Sen, Lu An-Qing, Wang Yong, Lei Wen-Zhang

机构信息

Department of Day Surgery Center, West China Hospital of Sichuan University, Chengdu, China.

West China School of Medicine, Sichuan University, West China Hospital of Sichuan University, Chengdu, China.

出版信息

Ann Transl Med. 2020 Jun;8(12):764. doi: 10.21037/atm-20-4572.

Abstract

BACKGROUND

Our study aims to explore the feasibility and safety of a double circular suturing technique (DCST) in the repair of giant incision hernias.

METHODS

The clinical data of 221 patients (95 men and 126 women; the average age was 61.6 years) receiving DCST in the repair of giant incision hernia between January 2010 and December 2018 was analyzed retrospectively. One hundred and five primary and 16 recurrent patients underwent herniorrhaphy with anti-adhesion underlay mesh repair using DCST.

RESULTS

All the 221 operations were performed successfully. The average preparation time before the operation and hospital stays were 3.7 days (range, 1-6 days) and 7.5 days (range, 2-16 days), respectively. The average diameter of the hernia ring defect observed intraoperatively was 16.4 cm (range, 12-22 cm). The average time of operation was 83.6 min (range, 43-195 min). There were 2 cases of intestinal fistula, 4 cases of wound infection, 2 cases of mesh infection, 7 cases of serum tumescence, 3 cases of pulmonary infection, and 2 cases of wound dehiscence occurred. One hundred and ninety-five patients were followed up for 6.7 years (range, 0.8-9.5 years) postoperatively. Of them, 9 patients recurred; 14 patients had chronic pain whose visual analog scale (VAS) was 2-4 cm (average 2.7 cm).

CONCLUSIONS

With limited preparation time before operations, few postoperative complications, and recurrence rate, DCST in the repair of giant incision hernia is safe and possible clinically.

摘要

背景

我们的研究旨在探讨双环缝合法(DCST)修复巨大切口疝的可行性和安全性。

方法

回顾性分析2010年1月至2018年12月期间接受DCST修复巨大切口疝的221例患者(95例男性和126例女性;平均年龄61.6岁)的临床资料。105例原发性患者和16例复发性患者采用DCST行疝修补术并加用抗粘连补片修补。

结果

221例手术均成功完成。术前平均准备时间和住院时间分别为3.7天(范围1 - 6天)和7.5天(范围2 - 16天)。术中观察到的疝环缺损平均直径为16.4 cm(范围12 - 22 cm)。平均手术时间为83.6分钟(范围43 - 195分钟)。发生肠瘘2例、伤口感染4例、补片感染2例、血清肿7例、肺部感染3例、伤口裂开2例。195例患者术后随访6.7年(范围0.8 - 9.5年)。其中,9例复发;14例有慢性疼痛,视觉模拟评分(VAS)为2 - 4 cm(平均2.7 cm)。

结论

DCST修复巨大切口疝术前准备时间有限,术后并发症少,复发率低,临床应用安全可行。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7420/7333136/58b7c8d8c796/atm-08-12-764-f1.jpg

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