负压双套管在腹壁巨大切口疝修补术中的应用

Application of Double Catheterization Cannula in Repair of Abdominal Giant Incisional Hernias

目的探讨双套管在腹壁巨大切口疝修补术中的临床应用价值。方法回顾分析2010年4月至2014年1月收治的13例腹壁巨大切口疝的临床资料。其中单纯腹壁巨大切口疝10例,腹壁巨大切口疝并结肠造口3例(其中1例存在造瘘口旁疝)。在常规补片无张力修补术的基础上加用双套管补片前方持续负压吸引。单纯腹壁巨大切口疝10例均未预防性应用抗生素。结果除1例合并结肠造口出现切口线头反应外,均一次性修补成功,无一例出现切口感染、切口血肿形成、切口积液等并发症。13例患者均痊愈出院。结论双套管引流可有效减少腹壁巨大切口疝修补术的并发症和抗生素的使用,是腹壁巨大切口疝修补术较好的引流方式。

Objective To investigate the clinical value of double cannula in repair of abdominal giant incisional hernias.Methods A retrospective analysis was performed in 13 patients who were treated between April 2010 and January 2014 for abdominal giant incisional hernias,including 10 patients with abdominal giant incisional hernias alone and 3patients with abdominal giant incisional hernias associated with colonic fistula（1patient with parastomal hernia）.On the basis of conventional tension-free patch repair,patients were given continuous vacuum suction in front of the double cannula patch.The 10 patients with abdominal giant incisional hernias alone received no prophylactic antibiotics.Results Incisional hernias were successfully repaired at the first attempt except in 1patient with complicated colonic fistula.All patients were cured and discharged from hospital without incision infection,hematoma formation,incision effusion and other complications.Conclusion Double cannula drainage can effectively reduce complications and antibiotic use in patients undergoing repair of abdominal giant incisional hernias.