Miyake Yuichiro, Watanabe Souta, Mizojiri Gaku, Maruyama Kentaro, Lee Kyowon, Oka Hiroshi
Department of Surgery, Moriguchi-Keijinkai Hospital, 2-47-12 Yagumo-higashimachi, Moriguchi, Osaka, 570-0021, Japan.
Surg Today. 2021 Oct;51(10):1649-1654. doi: 10.1007/s00595-021-02282-w. Epub 2021 Apr 17.
Abdominal incisional hernia is a frequent complication of major abdominal operations. Our method of performing mesh repair under the anterior lamina of the rectus sheath (MUAR) involves placing mesh between the dorsal surface of the anterior rectus sheath and the rectus abdominis muscle. We evaluated the short-term and long-term outcomes of our MUAR method.
The subjects of this retrospective study were 80 patients with abdominal incisional hernia, who underwent MUAR at our hospital between August, 2009 and September, 2018. We investigated the rate of recurrence and postoperative complications in these patients, who were followed-up postoperatively for at least 18 months. Patients who completed all visits were then followed-up further with questionnaires.
The recurrence rate after MUAR was 0%. Postoperative complications consisted of subcutaneous wound infections in two patients (2.5%), successfully treated with wound cleansing and antibiotics; and subcutaneous hematoma in three patients (3.8%), which was spontaneously absorbed in two patients, and removed in one. There were no other complications, such as seroma, intestinal obstruction, mesh infection and bulging, or prolonged postoperative pain.
Mesh repair under the anterior lamina of the rectus sheath is simple and safe with positive short-term and long-term outcomes, suggesting that it is a good option for incisional hernia repair.
腹部切口疝是腹部大手术常见的并发症。我们在腹直肌鞘前层下进行补片修补术（MUAR）的方法是将补片置于腹直肌鞘前层的背侧表面与腹直肌之间。我们评估了MUAR方法的短期和长期效果。
本回顾性研究的对象为80例腹部切口疝患者，他们于2009年8月至2018年9月在我院接受了MUAR手术。我们调查了这些患者的复发率和术后并发症，术后对他们进行了至少18个月的随访。完成所有随访的患者随后通过问卷调查进行进一步随访。
MUAR术后复发率为0%。术后并发症包括2例（2.5%）皮下伤口感染，经伤口清创和抗生素治疗成功；3例（3.8%）皮下血肿，其中2例自行吸收，1例清除。没有出现其他并发症，如血清肿、肠梗阻、补片感染和膨出，或术后长期疼痛。
腹直肌鞘前层下补片修补术简单安全，短期和长期效果良好，表明它是切口疝修补的一个好选择。
