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使用开放腹膜内双网片修补巨大切口疝

Giant Incisional Hernia Repair Using Open Intraperitoneal Dual Mesh.

作者信息

Korkut Ercan, Aksungur Nurhak, Altundaş Necip, Kara Salih, Peksöz Rıfat, Öztürk Gürkan

机构信息

General Surgery, Atatürk University Faculty of Medicine, Erzurum, TUR.

General Surgery, Atatürk University Research Hospital, Erzurum, TUR.

出版信息

Cureus. 2022 Jul 21;14(7):e27126. doi: 10.7759/cureus.27126. eCollection 2022 Jul.

Abstract

Aim Giant incisional herniae are larger than 15 cm and are typically treated with an open approach. Our aim was to highlight the outcomes of treating giant incisional hernia using open intraperitoneal dual mesh. Methods Between January 2015 and December 2021, 25 patients with giant incisional hernias, where fascial defects were 15-30 cm, were evaluated retrospectively. Intraperitoneal dual mesh was used in all patients. The patients were evaluated in terms of age, gender, body mass index (BMI), previous abdominal surgeries, defect diameter, anesthesia method, length of hospital stay, drain application, complications, and recurrence. Results Eleven of the patients were male and 14 were female. The mean age was 62±13.5 years (29-82 years). The average BMI was 32 kg/m2 (20-52 kg/m2). The mean size of the fascial defect was 22±5.5 cm (15-30). The mean operation time was 90 minutes (70-130 minutes). Six patients had type I and II complications according to the Clavien-Dindo classification, specifically superficial skin infections, skin erosion, subcutaneous bleeding, and temporary ileus due to intestinal adhesion. During the average follow-up period of 36 months (6-70 months), no major complications were observed related to the recurrence and use of dual mesh. Conclusion In the treatment of giant incisional hernia, open intraperitoneal dual mesh application should be kept in mind as an effective treatment option with low complication and recurrence rates.

摘要

目的 巨大切口疝大于15厘米,通常采用开放手术治疗。我们的目的是强调使用开放腹腔内双层补片治疗巨大切口疝的效果。方法 回顾性评估2015年1月至2021年12月期间25例巨大切口疝患者,其筋膜缺损为15 - 30厘米。所有患者均使用腹腔内双层补片。对患者进行年龄、性别、体重指数(BMI)、既往腹部手术史、缺损直径、麻醉方法、住院时间、引流应用、并发症及复发情况的评估。结果 患者中11例为男性,14例为女性。平均年龄为62±13.5岁(29 - 82岁)。平均BMI为32 kg/m²(20 - 52 kg/m²)。筋膜缺损的平均大小为22±5.5厘米(15 - 30厘米)。平均手术时间为90分钟(70 - 130分钟)。根据Clavien - Dindo分类,6例患者出现I型和II型并发症,具体为浅表皮肤感染、皮肤糜烂、皮下出血以及因肠粘连导致的暂时性肠梗阻。在平均36个月(6 - 70个月)的随访期内,未观察到与复发和双层补片使用相关的重大并发症。结论 在巨大切口疝的治疗中,开放腹腔内双层补片应用应作为一种并发症和复发率低的有效治疗选择予以考虑。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b332/9392680/09a0bfbcb4f7/cureus-0014-00000027126-i01.jpg

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