Kennedy G M, Matyas J A
Department of Surgery, Riverside Methodist Hospitals, Columbus, Ohio.
Am J Surg. 1994 Oct;168(4):304-6. doi: 10.1016/s0002-9610(05)80153-9.
Hernias that are not correctable by primary approximation require a prosthetic material to provide a tension-free repair. We report the results of 121 consecutive ventral (40) and inguinal (81) herniorrhaphies in 112 patients using the 2.0-mm expanded polytetrafluoroethylene (ePTFE) soft tissue patch. All follow-up was conducted by physical examination by the surgical team. Average follow-up was 49 months. Five patients (4%) experienced complications: there was 1 inguinal recurrence, 1 ventral recurrence, 1 seroma, 1 wound infection, and 1 prolonged gastrocutaneous fistula. The cause of one of the recurrences is unknown because the patient refused further surgery. The seroma resolved spontaneously after two aspirations. The remaining three complications were considered to be unrelated to the implantation of the prosthetic patch. There were no complications due to adhesions, bowel erosion, or bowel obstruction in the ventral repairs. On the basis of our clinical experience, we believe that ePTFE is an acceptable mode of treatment for all difficult hernias.
无法通过一期缝合修复的疝需要使用人工材料来进行无张力修补。我们报告了112例患者连续进行的121例腹疝（40例）和腹股沟疝（81例）修补术的结果，使用的是2.0毫米的膨化聚四氟乙烯（ePTFE）软组织补片。所有随访均由手术团队进行体格检查。平均随访时间为49个月。5例患者（4%）出现并发症：1例腹股沟疝复发，1例腹疝复发，1例血清肿，1例伤口感染，1例长期胃皮肤瘘。其中1例复发原因不明，因为患者拒绝进一步手术。血清肿经两次抽吸后自行消退。其余3例并发症被认为与人工补片植入无关。腹疝修补术中未出现因粘连、肠侵蚀或肠梗阻导致的并发症。基于我们的临床经验，我们认为ePTFE是所有难复性疝的一种可接受的治疗方式。
