腹部巨大切口疝的外科治疗

Surgical Treatment of Abdominal Giant Incisional Hernia

目的 总结临床治疗腹部巨大切口疝的经验和体会。方法 对 1979年 12月至 1999年 1月间收治的7例巨大腹部切口疝 (腹壁缺损 >15cm)的病人进行随访、分析和总结。腹部巨大切口疝手术治疗成功的关键是术前扩大腹腔容量和增强心肺功能的适应性训练 ,手术为一期自体组织修复。结果 术后患者恢复顺利。所有病例均获得 10月至 16年 (平均 5 .2年 )的随访 ,无一例复发 ;除两例因其他疾病分别于疝修补术后 12年和 3年死亡外 ,其余均恢复正常活动。结论 与国外采用的术前反复气腹扩大腹腔容量和术中人造织物修补缺损不同 ,本组对 7例腹部巨大切口疝均一期修补成功 ,无一例复发 ,临床疗效令人满意。

Purpose To present our experience in treatment of abdominal giant incisional hernia (abdominal defect>15 cm). Methods Analysis and follow up were made in seven patients with abdominal giant incisional hernia treated between December 1979 and January 1999.The key points of success in treatment of abdominal giant incisional hernial are preoperative expanding of abdominal cavity and improving of function of heart and lungs. Results All seven patients were cured and followed up for ten monthes to 16 years (average 5.2 years) without recurrence.All patients have recovered to normal activities postoperatively. Conclusions Abdominal Giant incisional hernia is aclinical rarity.Its treatment is very difficult.Our experiences show that abdominal giant incisional hernia may be successfully repaired without repeated preoperative pnenmoperitoneum and artificial tissue with optimal results.