腹直肌后补片修补术治疗中线腹壁疝
Retrorectus prosthetic mesh repair of midline abdominal hernia.
作者信息
McLanahan D, King L T, Weems C, Novotney M, Gibson K
机构信息
Department of Surgery, Pacific Medical Center, Seattle, Washington 98144, USA.
出版信息
Am J Surg. 1997 May;173(5):445-9. doi: 10.1016/S0002-9610(97)89582-7.
BACKGROUND
Midline abdominal hernia is a common problem seen by the general surgeon. Recurrence rates are as high as 49% when an autogenous repair is performed, and as high as 11% when prosthetic mesh is used as a "bridge" or "onlay."
METHODS
This study analyzes results of midline abdominal hernia repair in 106 cases using prosthetic mesh, in the retrorectus position, as described by Stoppa and Wantz. Charts were reviewed, patient satisfaction determined by telephone interview, and recurrence rate by physician examination.
RESULTS
Major systemic complications occurred in 17%. There were no deaths. Eighteen percent developed a wound complication, requiring a return to the operating room in 5%. There were three recurrences (3.5%).
CONCLUSIONS
Retrorectus placement of prosthetic mesh in the repair of midline abdominal hernia is effective and compares favorably with other methods. Significant complications are low, recurrence is rare, and patient satisfaction is high.
背景
腹正中疝是普通外科医生常见的诊治问题。采用自体组织修补时复发率高达49%，使用人工合成补片作为“桥接”或“覆盖”修补时复发率高达11%。
方法
本研究分析了106例采用Stoppa和Wantz描述的腹直肌后间隙人工合成补片修补腹正中疝的结果。查阅病历，通过电话访谈确定患者满意度，通过医生检查确定复发率。
结果
17%发生严重全身并发症。无死亡病例。18%发生伤口并发症，其中5%需要再次手术。有3例复发（3.5%）。
结论
腹直肌后间隙放置人工合成补片修补腹正中疝有效，与其他方法相比具有优势。严重并发症发生率低，复发罕见，患者满意度高。
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