Division of Plastic and Reconstructive Surgery, Department of Surgery, Feinberg School of Medicine, Northwestern University, 259 E Erie St., Suite 20-2060, Chicago, Illinois, 60611, USA.
Hernia. 2024 Dec;28(6):2207-2216. doi: 10.1007/s10029-024-03133-6. Epub 2024 Aug 30.
The ultimate measure of successful abdominal wall reconstruction is a pain-free, complication-free, and durable hernia repair. Open techniques have generally lost favor, but they still have much to offer for patients with skin deficits and excess. The long-term complication rates for open hernia repairs is unknown. Electronic medical records now provide the ability to easily follow patients who have switched medical institutions. Using this tool, we followed a cohort of abdominal wall reconstruction patients who had an early high "success" rate.
We performed a retrospective chart review of 101 patients who underwent open ventral hernia repair with a narrow well-fixed retrorectus uncoated polypropylene mesh by a single surgeon (GAD) between the years of 2010 and 2015. These patients were initially reported in a 2016 publication. Patients' post-operative follow-up by any medical provider assessing the abdominal region were studied up until August 2023. Patient demographics, operative reports, and postoperative course were re-reviewed.
A total of 101 patients underwent ventral hernia repair. Mean follow-up time was 7.68 years (range 1.8 - 13.0 years). There were no recurrent hernias across the studied time period and no instances of enterocutaneous fistulas. 15 patients (15%) had abdominal surgery after hernia repair unrelated to their original surgery and 5 patients (5%) reported chronic post-operative pain. 13 patients died in the follow-up period, all unrelated to the abdominal wall surgery.
Open well-fixed narrow retrorectus mesh hernia repairs perform well in the long-term without fistulas, extrusions, and hernia recurrence.
成功的腹壁重建的最终衡量标准是无痛、无并发症和持久的疝修补。开放式技术通常已不再流行，但对于存在皮肤缺损和过多的患者，它们仍然有很多优势。开放式疝修补术的长期并发症发生率尚不清楚。电子病历现在提供了方便随访已转至其他医疗机构的患者的能力。利用这一工具，我们随访了一组腹壁重建患者，他们在早期有很高的“成功率”。
我们对 2010 年至 2015 年间由一位外科医生（GAD）采用窄而固定的后腹膜无涂层聚丙烯网片进行开放式腹侧疝修补的 101 例患者进行了回顾性图表审查。这些患者最初在 2016 年的一篇文章中报道过。研究了任何评估腹部区域的医疗提供者对这些患者的术后随访情况，随访时间截至 2023 年 8 月。重新审查了患者的人口统计学资料、手术报告和术后病程。
共有 101 例患者接受了腹侧疝修补术。平均随访时间为 7.68 年（范围 1.8-13.0 年）。在研究期间没有复发性疝，也没有肠外瘘的发生。15 例患者（15%）在疝修补术后进行了与原始手术无关的腹部手术，5 例患者（5%）报告有慢性术后疼痛。在随访期间有 13 例患者死亡，均与腹壁手术无关。
开放式固定良好的窄后腹膜网片疝修补术在长期随访中表现良好，无瘘管、脱出和疝复发。
