Horhant P, Le Du J, Chaperon J, Lavenac G, Mambrini A
Service de Chirurgie Générale A (Pr. A. Mambrini), Hôpital Sud, C.H.R. de Rennes.
J Chir (Paris). 1996 Nov;133(7):311-6.
We reviewed retrospectively a series of eventrations treated with a nonresorbable prosthesis. Most of the eventrations occurred after medial laparotomies (83.7%), predominantly with sub-umbilical incision (42.5%) and often after gynecological or biliary surgery (31.9 and 27.5% respectively). Predisposing factors were obesity (38.1%) and post-operative infection of the suture (21%). Delay to eventration was 5.5 years (range 1 to 30 years). In 17% of the cases recurrent eventration was seen after one or more cures (maximum of 5). The prosthesis was always positioned behind the muscle, either ventrally to the posterior sheath of the rectus abdominis or directly in a properitoneal position. Resorbable U sutures (41.2%) or stapling were used. There was one post-operative death due to massive pulmonary embolism on day 10. Morbidity was 8.1% (4 respiratory complications, 4 pulmonary embolisms, 1 intestinal occlusion due to loop agglutination, 9 hematomas including 6 requiring reoperation). There were also 11 cases of infection of the suture with 3 involving the prosthesis. Long-term follow-up of 149 patients (93.1%) revealed on death related to former repair.
我们回顾性分析了一系列采用不可吸收假体治疗的腹疝病例。大多数腹疝发生在内侧剖腹手术后（83.7%），主要是脐下切口（42.5%），且常发生在妇科或胆道手术后（分别为31.9%和27.5%）。诱发因素为肥胖（38.1%）和缝线术后感染（21%）。发生腹疝的延迟时间为5.5年（范围1至30年）。17%的病例在一次或多次治愈后（最多5次）出现复发性腹疝。假体总是置于肌肉后方，要么在腹直肌后鞘前方，要么直接置于腹膜后位置。使用了可吸收U形缝线（41.2%）或吻合器。术后第10天有1例因大面积肺栓塞死亡。发病率为8.1%（4例呼吸并发症、4例肺栓塞、1例因肠袢粘连导致的肠梗阻、9例血肿，其中6例需要再次手术）。还有11例缝线感染，3例累及假体。对149例患者（93.1%）的长期随访显示无与先前修复相关的死亡。
