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网片外置与内置技术在切口疝修补术中的应用:30 天术后结果。

ONLAY VERSUS SUBLAY TECHNIQUES FOR INCISIONAL HERNIA REPAIR: 30-DAY POSTOPERATIVE OUTCOMES.

机构信息

University Hospital of Porto Alegre, Digestive Diseases Surgical Unit - Porto Alegre (RS), Brazil.

University Hospital of Porto Alegre, General Surgery Unit - Porto Alegre (RS), Brazil.

出版信息

Arq Bras Cir Dig. 2022 Nov 14;35:e1692. doi: 10.1590/0102-672020220002e1692. eCollection 2022.

Abstract

BACKGROUND

The development of an incisional hernia is a common complication following laparotomy. It also has an important economic impact on healthcare systems and social security budget. The mesh reinforcement of the abdominal wall was an important advancement to increase the success of the repairs and reduce its long-term recurrence. The two most common locations for mesh placement in ventral hernia repairs include the premuscular (onlay technique) and retromuscular planes (sublay technique). However, until now, there is no consensus in the literature about the ideal location of the mesh.

AIM

The aim of this study was to compare the two most common incisional hernia repair techniques (onlay and sublay) with regard to the complication rate within the first 30 days of postoperative care.

METHOD

This study analyzes 115 patients who underwent either onlay or sublay incisional hernia repairs and evaluates the 30-day postoperative surgical site occurrences and hernia recurrence for each technique.

RESULTS

We found no difference in the results between the groups, except in seroma formation, which was higher in patients submitted to the sublay technique, probably due to the lower rate of drain placement in this group.

CONCLUSION

Both techniques of mesh placement seem to be adequate in the repair of incisional hernias, with no major difference in surgical site occurrences.

摘要

背景

切口疝是剖腹手术后的一种常见并发症。它对医疗保健系统和社会保障预算也有重要的经济影响。腹壁网片加强是提高修复成功率和降低长期复发率的重要进展。在腹疝修复中,最常见的两种网片放置位置包括肌前(覆盖技术)和肌后(下置技术)。然而,到目前为止,文献中尚未就网片的理想位置达成共识。

目的

本研究旨在比较两种最常见的切口疝修复技术(覆盖技术和下置技术)在术后 30 天内的并发症发生率。

方法

本研究分析了 115 例接受覆盖或下置切口疝修复的患者,并评估了两种技术的 30 天术后手术部位发生的情况和疝复发率。

结果

除了血清肿形成外,我们发现两组之间的结果没有差异,下置技术组的血清肿发生率更高,可能是由于该组引流管放置率较低所致。

结论

两种网片放置技术在切口疝修复中似乎都是足够的,在手术部位发生方面没有明显差异。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5fcc/9668271/143382cae119/0102-6720-abcd-35-e1692-gf01.jpg

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