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一种新型聚丙烯网片(T-Line®)在腹壁修复中的应用:美国三个中心的早期经验。

A Novel Polypropylene Mesh (T-Line®) for Abdominal Wall Repair: Early Experience at Three Centers in the United States.

机构信息

Department of Surgery, Montefiore Medical Center, New York, NY, USA.

Department of Surgery, UCSF, San Francisco, CA, USA.

出版信息

Surg Technol Int. 2023 Sep 15;42:163-167. doi: 10.52198/23.STI.42.HR1649.

Abstract

Mesh suture was initially developed and investigated to overcome suture pull-through in hernia repair. It has a large area compared to standard suture which distributes the load in tissue, reducing stress at the suture/tissue interface and preventing suture from cutting through tissue or the mesh. This report describes our early experience using the new T-line® mesh (Deep Blue Medical Advances, Durham, NC, USA) in patients with incisional and primary ventral hernia repairs. This is a descriptive, retrospective study in 18 patients who underwent abdominal wall repair with T-Line® mesh from November 2020 to November 2021 in three academic centers. T-Line® is a novel moderate-weight macroporous, polypropylene mesh with extensions that are 29 times the cross-sectional area of #0 polypropylene suture. They can be sewn into fascia to anchor the mesh with no need for suture tackers or other devices to fixate the mesh. The median age of the patients was 56.5 years (range 25-83) and the median BMI was 31.7 kg/m2 (range 23.6-51). Twelve patients (66.7%) had primary hernias, and 11 (61.1%) had a recurrent hernia. The median defect area was 117.5 cm2 (range 4-390) and the median mesh area was 449.5 cm2 (range 130-600). The mesh position was onlay in 16 cases (88.9%) and sublay in 2 cases (11.1%). The median operative time was 247 minutes (range 104-395). The median length of stay was six days (range 0-21) with no significant in-hospital complications. One patient had a surgical site infection (5.5%) and two patients developed seromas (11.1%). There were no early hernia recurrences with a median follow-up of 28 days (range 8-307). The T-Line® mesh was shown to be safe and effective for patients with ventral hernia in the short term.

摘要

网片缝合最初是为了克服疝修补术中缝线滑脱而开发和研究的。与标准缝线相比,它的面积更大,能够在组织中分布负荷,减少缝线/组织界面的应力,并防止缝线穿过组织或网片。本报告介绍了我们在三家学术中心使用新型 T 线®网片(美国北卡罗来纳州达勒姆市 Deep Blue Medical Advances)治疗切口疝和原发性腹疝患者的早期经验。这是一项回顾性研究,纳入了 2020 年 11 月至 2021 年 11 月期间在三家学术中心接受 T 线®网片腹壁修补术的 18 例患者。T 线®是一种新型的中重量、大孔、聚丙烯网片,其延伸部分是 #0 聚丙烯缝线横截面面积的 29 倍。它们可以缝合到筋膜中,以锚定网片,无需缝线钉或其他固定网片的设备。患者的中位年龄为 56.5 岁(范围 25-83 岁),中位 BMI 为 31.7kg/m2(范围 23.6-51)。12 例患者(66.7%)为原发性疝,11 例(61.1%)为复发性疝。中位缺损面积为 117.5cm2(范围 4-390),中位网片面积为 449.5cm2(范围 130-600)。16 例(88.9%)为网片置于腹外斜肌腱膜前,2 例(11.1%)为置于腹外斜肌腱膜后。中位手术时间为 247 分钟(范围 104-395)。中位住院时间为 6 天(范围 0-21),无显著院内并发症。1 例患者发生手术部位感染(5.5%),2 例患者发生血清肿(11.1%)。中位随访 28 天(范围 8-307),无早期疝复发。T 线®网片在短期内对腹疝患者是安全有效的。

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