腹膜前置补片修补法治疗腹壁切口疝的临床探讨

Analysis of sublay prosthetic repair for abdominal incisional hernias

目的：探讨在开放手术中补片修补腹壁切口疝的有效方法。方法回顾性分析2004年1月-2012年12月经大连医科大学附属第一医院诊治的腹壁切口疝患者中开放手术128例患者的临床资料。其中2例行肌间置补片修补法（Inlay），25例行肌筋膜前置补片修补法（Onlay），101例行腹膜前置补片修补法（Sublay）。观察3种方法的疗效。结果128例均痊愈出院，无严重并发症，随访5～48个月， Inlay组复发1例（50％）， Onlay组复发5例（20％）， Sublay组复发4例（4％）。结论 Sublay法治疗腹壁切口疝复发率低，在开放手术中是治疗腹壁切口疝的理想方法。

Objective To discuss clinical effective methods for repairing abdominal incisional hernias with mesh in the open surgery .Methods One hundred and twenty -eight cases of abdominal incisional hernia in the open surgery were ana-lyzed retrospectively in our hospital from Jan 2004 to Dec 2012 .Two cases were repaired with Inlay , 25 cases with Onlay and 101 cases with Sublay .The treatment effects of the three methods were compared .Results All of the cases were cured with no serious postoperative complications .Among all cases who were followed up during 5-48 months, 1 case recurred in the group of Inlay（50%）, 5 cases recurred in the group of Onlay（20%）and 4 cases recurred in the group of Sublay （4%）.Conclusion Sublay has a lower recurrence rate , thus is considered as a satisfactory model for repair of abdominal incisional hernias in the open surgery .