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脐旁疝补片修补术早期并发症的探索:一项为期六个月的严谨前瞻性研究及深入分析

Exploring Early Complications in Paraumbilical Hernia Mesh Repair: A Rigorous Six-Month Prospective Study and In-Depth Analysis.

作者信息

Ullah Niamat, Sharif Gul, Salman Muhammad, Khan Shinwari Sajjad Muhammad, Amin Qazi Kamran

机构信息

General Surgery, Medical Teaching Institute, Lady Reading Hospital, Peshawar, PAK.

General Surgery, Lady Reading Hospital, Peshawar, PAK.

出版信息

Cureus. 2024 Nov 9;16(11):e73348. doi: 10.7759/cureus.73348. eCollection 2024 Nov.

Abstract

Introduction When an organ, such as the colon, pushes through the wall of the abdominal cavity, a hernia results. After femoral and inguinal hernias, umbilical hernias account for the third most common kind of abdominal hernia in adults precipitated by conditions such as obesity, ascites, and repeated pregnancies. A subtype of umbilical hernias called paraumbilical hernias is more likely to cause problems such as rupture, skin ulceration, and obstruction. Seroma, hematoma, and infection are the reported post-repair consequences but data regarding early complications is limited. High-quality data assessing early complications is necessary to improve mesh repair outcomes. Materials and methods This cross-sectional study was carried out in the Department of General Surgery at Medical Teaching Institute (MTI) Lady Reading Hospital, Peshawar over one year, from January to December 2022. A total of 167 patients were selected using simple random sequential selection. Patients aged 20-60 years of both genders who were diagnosed with paraumbilical hernia in the emergency department were included. To prevent bias, those with uncontrolled diabetes or existing complications from hernia were excluded. Following informed consent, data were gathered using pre-designed proformas. Patients underwent open mesh repair during each surgery, and they were monitored at one and three months following the procedure. Complications such as seroma, hematoma, and wound infection were documented. Data were analyzed using SPSS version 20 (IBM Corp., Armonk, NY) with chi-square tests for categorical variables and a significance level of p < 0.05. Results The study included a total of 167 patients, with a mean age of 42 years (SD ±8.77). The majority of patients (40%) ranged in age from 41 to 50 years old, with 33% aged 31 to 40. Gender distribution revealed that 63 (38%) of the patients were male and 104 (62%) were female. Early complications included 25 (15%) wound infections, 32 (19%) seromas, and 63 (38%) hematomas. The occurrence of wound infections, seromas, and hematomas did not differ significantly by age or gender (p > 0.05). Conclusion Early complications from paraumbilical hernia mesh repair include wound infections (15%), seromas (19%), and hematomas (38%). Postoperative monitoring is critical to reducing these complications.

摘要

引言 当一个器官,如结肠,穿过腹腔壁时,就会形成疝气。在股疝和腹股沟疝之后,脐疝是成人中第三常见的腹部疝,由肥胖、腹水和多次怀孕等情况引发。脐疝的一种亚型称为脐旁疝,更有可能导致破裂、皮肤溃疡和梗阻等问题。血清肿、血肿和感染是报道的修复后后果,但关于早期并发症的数据有限。评估早期并发症的高质量数据对于改善补片修复结果是必要的。

材料和方法 这项横断面研究于2022年1月至12月在白沙瓦莱迪·里德医院医学教学研究所(MTI)普通外科进行了一年。使用简单随机顺序选择法共选取了167例患者。纳入在急诊科被诊断为脐旁疝的20至60岁的男女患者。为防止偏倚,排除患有未控制的糖尿病或已有疝气并发症的患者。在获得知情同意后,使用预先设计的表格收集数据。每位患者在每次手术中接受开放式补片修复,并在术后1个月和3个月进行监测。记录血清肿、血肿和伤口感染等并发症。使用SPSS 20版(IBM公司,纽约州阿蒙克)对数据进行分析,分类变量采用卡方检验,显著性水平为p < 0.05。

结果 该研究共纳入167例患者,平均年龄为42岁(标准差±8.77)。大多数患者(40%)年龄在41至50岁之间,33%年龄在31至40岁之间。性别分布显示,63例(38%)患者为男性,104例(62%)为女性。早期并发症包括25例(15%)伤口感染、32例(19%)血清肿和63例(38%)血肿。伤口感染、血清肿和血肿的发生率在年龄或性别上无显著差异(p > 0.05)。

结论 脐旁疝补片修复的早期并发症包括伤口感染(15%)、血清肿(19%)和血肿(38%)。术后监测对于减少这些并发症至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/02d9/11627529/c0c81d640963/cureus-0016-00000073348-i01.jpg

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