Creighton University School of Medicine, Omaha, NE, 68178, USA.
Creighton University School of Medicine, Omaha, NE, 68178, USA; Department of Surgery, Creighton University Medical Center, Omaha, NE, 68131, USA.
Am J Surg. 2021 May;221(5):942-949. doi: 10.1016/j.amjsurg.2020.09.004. Epub 2020 Sep 7.
Incisional hernias (IH) following a laparotomy, on average, occur in 10-20% of patients, however, little is known about its molecular basis. Thus, a better understanding of the molecular mechanisms could lead to the identification of key target(s) to intervene pre-and post-operatively.
We examined the current literature describing the molecular mechanisms of IH and overlap these factors with smoking, abdominal aortic aneurysm, obesity, diabetes mellitus, and diverticulitis.
The expression levels of collagen I and III, matrix metalloproteinases, and tissue inhibitors of metalloproteases are abnormal in the extracellular matrix (ECM) of IH patients and ECM disorganization has an overlap with these comorbid conditions.
Understanding the pathophysiology of IH development and associated risk factors will allow physicians to identify patients that may be at increased risk for IH and to possibly act preemptively to decrease the incidence of IH.
剖腹手术后切口疝（IH）的平均发病率为 10-20%，但其分子基础知之甚少。因此，更好地了解分子机制可能有助于确定术前和术后干预的关键靶点。
我们查阅了描述 IH 分子机制的现有文献，并将这些因素与吸烟、腹主动脉瘤、肥胖、糖尿病和憩室炎进行了比较。
IH 患者细胞外基质（ECM）中胶原 I 和 III、基质金属蛋白酶和金属蛋白酶组织抑制剂的表达水平异常，ECM 紊乱与这些合并症重叠。
了解 IH 发展的病理生理学和相关危险因素将使医生能够识别出可能患有 IH 风险增加的患者，并可能采取先发制人的措施降低 IH 的发生率。
