开放式合成材料补片修补腹壁疝217例的经验总结

Open ventral hernia repair by application of a prosthetic patch(a report of 217 cases)

目的:评价开放的合成材料补片修补腹壁疝的效果和并发症。方法:回顾性分析1999年4月至2008年4月行此法修补之腹壁疝217例的临床资料,包括切口疝184例和脐疝33例。应用肌前修补法(onlay法)59例,肌后修补法(sublay法)84例,腹腔内补片修补法(IPOM法)74例。198例病人获得随访,时间为4～108个月,平均57个月。结果:术后血清肿发生率为5.5%,(12/217),onlay组血清肿发生率显著高于sublay组(P<0.05),而与IPOM组无显著差别。总切口感染率为1.4%(3/217),各组间切口感染率无显著差别。术后总复发率为3.0%(6/198),onlay组术后复发率显著高于sublay组和IPOM组(分别P<0.05)。结论:开放式合成材料补片修补腹壁疝是安全有效的外科治疗方法,其中以sublay法更为合理。

Objective To observe the efficacy and complications of open ventral hernia repair by application of a prosthetic patch. Methods The clinical data from 217 patients undergoing open ventral hernia repair by application of a prosthetic patch, from April 1999 to April 2008, were retrospectively analyzed. Among all these patients, 59 cases underwent the onlay procedure, 84 cases the sublay procedure, and 74 cases the intraperitoneal onlay mesh （IPOM）, procedure. Results The overall rate of postoperative seroma occurence was 5.5% （12/217）. The rate of seroma occnrence was significantly higher in the onlay group than that in the sublay group （P〈0.05）. The overall rate of incisional infection was 1.4%（3/217）, no difference was observed among the 3 groups. The overall recurrence rate was 3.0% （6/198）; it was significantly higher in the onlay group than that of the other 2 groups （P〈0.05）. Conclusions Open ventral hernia repair by application of a prosthetic patch is both safe and effective. The sublay technique is more effective than the other 2 procedures.