Schumpelick V, Conze J, Klinge U
Chirurgische Universitätsklinik und Poliklinik, RWTH Aachen.
Chirurg. 1996 Oct;67(10):1028-35. doi: 10.1007/s001040050099.
In a retrospective study on 245 patients we evaluated the results of 272 incisional hernia repairs in the Department Surgery of the University Hospital Aachen. The group consisted of 58% male and 42% female patients with a mean age of 61.1 years and 111 primary and 161 recurrent incisional hernias. Conventional techniques (simple closure, Mayo) and alloplastic repairs were performed in 69.9 and 30.1%, respectively. During the last 4 years we predominantly used the preperitoneal mesh repair with polypropylene mesh (Marlex). The results of 87% of our group of patients were evaluated by questionnaire and information from the family physicians (mean follow-up period 64 months). The patients who underwent preperitoneal mesh repair were examined clinically and with ultrasound. In comparison to the results of conventional hernia repair, early complications (seroma, hematoma) were higher. The recurrence rate, however, was significantly lower in this group with mesh repair (6.8%) than in patients without alloplastic augmentation (32.6%). Whereas preperitoneal mesh repair is convincingly the ideal surgical technique, optimization of the alloplastic materials by reduction of the amount of foreign substance and improvement of elasticity and biocompatibility is mandatory.
在一项针对245例患者的回顾性研究中，我们评估了亚琛大学医院外科进行的272例切口疝修补术的结果。该组患者中男性占58%，女性占42%，平均年龄为61.1岁，其中有111例原发性切口疝和161例复发性切口疝。分别有69.9%和30.1%的患者采用了传统技术（单纯缝合、梅奥术式）和人工材料修补术。在过去4年中，我们主要采用聚丙烯网片（Marlex）进行腹膜前网片修补术。我们通过问卷调查和家庭医生提供的信息对87%的患者组的结果进行了评估（平均随访期64个月）。对接受腹膜前网片修补术的患者进行了临床检查和超声检查。与传统疝修补术的结果相比，早期并发症（血清肿、血肿）发生率更高。然而，该网片修补组的复发率（6.8%）明显低于未采用人工材料增强的患者组（32.6%）。虽然腹膜前网片修补术无疑是理想的手术技术，但必须通过减少异物量以及改善弹性和生物相容性来优化人工材料。
