Patrone Renato, Leongito Maddalena, di Giacomo Raimondo, Belli Andrea, Palaia Raffaele, Amore Alfonso, Albino Vittorio, Piccirillo Mauro, Cutolo Carmen, Coluccia Sergio, Nasto Aurelio, Conzo Giovanni, Crispo Anna, Granata Vincenza, Izzo Francesco
Dieti Department, University of Naples Federico II, 80100 Naples, Italy.
Division of Hepatobiliary Surgical Oncology, Istituto Nazionale Tumori IRCCS Fondazione Pascale-IRCCS di Napoli, 80131 Naples, Italy.
J Clin Med. 2022 Oct 13;11(20):6035. doi: 10.3390/jcm11206035.
Up to 28% of all patients who undergo open surgery will develop a ventral hernia (VH) in the post-operative period. VH surgery is a debated topic in the literature, especially in oncological patients due to complex management. We searched in the surgical database of the Hepatobiliary Unit of the National Cancer Institute of Naples "G. Pascale Foundation" for all patients who underwent abdominal surgery for malignancy from January 2010 to December 2018. Our surgical approach and our choice of mesh for VH repair was planned case-by-case. We selected 57 patients that fulfilled our inclusion criteria, and we divided them into two groups: biological versus synthetic prosthesis. Anterior component separation was used in 31 patients (54.4%) vs. bridging procedure in 26 (45.6%). In 41 cases (71.9%), we used a biological mesh while a synthetic one was adopted in the remaining patients. Of our patients, 57% were male (33 male vs. 24 female) with a median age of 65 and a mean BMI of 30.8. We collected ventral hernia defects from 35 cm to 600 cm (mean 205.2 cm); 30-day complications were present in 24 patients (42.1%), no 30-day mortality was reported, and 21 patients had a recurrence of pathology during study follow-up. This study confirms VH recurrence risk is not related with the type of mesh but is strongly related with BMI and type of surgery also in oncological patients.
接受开放手术的所有患者中，高达28%会在术后发生腹侧疝（VH）。VH手术是文献中一个有争议的话题，尤其是在肿瘤患者中，因为管理复杂。我们在那不勒斯国家癌症研究所“G. 帕斯卡尔基金会”肝胆科的手术数据库中搜索了2010年1月至2018年12月期间因恶性肿瘤接受腹部手术的所有患者。我们的手术方法和VH修复所用补片的选择是逐例规划的。我们选择了57例符合纳入标准的患者，并将他们分为两组：生物补片组与合成补片组。31例患者（54.4%）采用前入路分离术，26例患者（45.6%）采用桥接手术。41例患者（71.9%）使用了生物补片，其余患者采用了合成补片。我们的患者中，57%为男性（33例男性 vs. 24例女性），中位年龄为65岁，平均BMI为30.8。我们收集的腹侧疝缺损范围为35 cm至600 cm（平均205.2 cm）；24例患者（42.1%）出现30天并发症，未报告30天死亡率，21例患者在研究随访期间出现病理复发。这项研究证实，在肿瘤患者中，VH复发风险与补片类型无关，但与BMI和手术类型密切相关。
