Trehan Munish, Aggarwal Kunwar, Singh Jaspal, Singla Sanjeev, Garg Ramneesh
Department of General Surgery, Dayanand Medical College and Hospital, Ludhiana, Punjab, India.
Department of Plastic Surgery, Dayanand Medical College and Hospital, Ludhiana, Punjab, India.
Int J Appl Basic Med Res. 2021 Jan-Mar;11(1):40-43. doi: 10.4103/ijabmr.IJABMR_530_20. Epub 2021 Jan 26.
Incisional hernia remains a frequent complication of abdominal surgery. Results of surgical repair are disappointing with recurrence rates of suture repair being in the range of 5%-63% depending on the type of repair used, with better results using mesh implantation. For the management of such large hernias, interest has been generated in the Component Separation Technique. This technique relaxes abdominal wall by translation of muscular layers without severing the innervation and blood supply, with or without the mesh augmentation. This can accommodate for defects up to 25-30 cm in the waistline.
The study was conducted on 20 patients with "Large Incisional Hernia" with defect size >5 cm at its maximum width or with a surface area >50 cm operated upon with Component Separation. Clinical outcome was measured over a follow-up period of 3 months from the surgery in terms of recurrence and other local complications.
There were 20 patients (3 men and 17 women; 70% of cases above the age of 50 years). Mean defect size was 9.5 cm (range = 6-20 cm). Average body mass index was 28.97 kg/m (range = 22-37 kg/m). Mean duration of hospital stay was 9 days (range = 5-21 days). Early complications occurred in 15% (3/20) cases and postoperative abdominal compartment or recurrence was not reported over a follow-up period of 3 months.
Component Separation Technique is a safe, easy, and quick option for patients with large hernias.
切口疝仍是腹部手术常见的并发症。手术修复结果令人失望,缝线修复的复发率在5%-63%之间,具体取决于所采用的修复类型,使用补片植入的效果更好。对于此类大型疝的治疗,人们对成分分离技术产生了兴趣。该技术通过肌肉层的平移来松弛腹壁,而不切断神经和血供,可使用或不使用补片增强。这可以容纳腰围达25-30厘米的缺损。
对20例“大型切口疝”患者进行了研究,这些患者的最大宽度缺损尺寸>5厘米或表面积>50平方厘米,采用成分分离技术进行手术。从手术起随访3个月,根据复发情况和其他局部并发症来衡量临床结果。
共有20例患者(3例男性和17例女性;70%的病例年龄在50岁以上)。平均缺损尺寸为9.5厘米(范围=6-20厘米)。平均体重指数为28.97千克/平方米(范围=22-37千克/平方米)。平均住院时间为9天(范围=5-21天)。15%(3/20)的病例出现早期并发症,在3个月的随访期内未报告术后腹腔间隔综合征或复发情况。
成分分离技术对于大型疝患者是一种安全、简便且快速的选择。