Balén E M, Díez-Caballero A, Hernández-Lizoáin J L, Pardo F, Torramadé J R, Regueira F M, Cienfuegos J A
Department of General Surgery, Clinica Universitaria, University of Navarra, Pamplona, Spain.
Br J Surg. 1998 Oct;85(10):1415-8. doi: 10.1046/j.1365-2168.1998.00849.x.
Operations for large and recurrent abdominal hernias have a high associated recurrence rate, although it is lower when prosthetic material is used. Expanded polytetrafluoroethylene (ePTFE) seems to be the best tolerated prosthetic material in surgery.
A series of 45 ventral hernias repaired using ePTFE for closure or reinforcement of the herniorrhaphy has been evaluated prospectively. Thirty-six were midline incisional hernias and nine were transverse or pararectal ventral hernias. There were 13 recurrent ventral hernias and three defects were operated as an emergency procedure. The patch was sutured to the anterior aponeurosis with a running non-absorbable suture. Some other kind of intra-abdominal procedure was undertaken in 12 cases.
ePTFE was well tolerated. Complications occurred in five patients. Major complications were found in three patients: cutaneous necrosis requiring a myocutaneous flap; and infection of the prosthesis (primary, and secondary to enterocutaneous fistula due to diverticulitis, both requiring removal of the patch). Mean follow-up was 39 months and hernia recurrence occurred in only one patient.
This clinical experience shows that ePTFE is a very reliable prosthetic material for the repair of abdominal wall hernias.
尽管使用人工材料时复发率较低，但大型和复发性腹疝手术的复发率仍较高。在手术中，膨体聚四氟乙烯（ePTFE）似乎是耐受性最佳的人工材料。
前瞻性评估了一系列45例使用ePTFE修复腹疝或加强疝修补术的病例。其中36例为中线切口疝，9例为横形或直肠旁腹疝。有13例复发性腹疝，3例因紧急情况进行手术。补片用连续不可吸收缝线缝合至腹直肌前鞘。12例患者还进行了其他某种腹部手术。
ePTFE耐受性良好。5例患者出现并发症。3例患者出现严重并发症：皮肤坏死需要行肌皮瓣修复；假体感染（1例原发性，1例因憩室炎导致肠皮肤瘘继发感染，均需取出补片）。平均随访39个月，仅1例患者疝复发。
该临床经验表明，ePTFE是修复腹壁疝非常可靠的人工材料。
