生物补片联合自身腹膜折叠修补巨大腹壁切口疝

Repairing huge abdominal incisional hernias with biological patch and autogeneic peritoneum

目的:研究生物补片联合自身腹膜折叠修补巨大腹壁切口疝的临床应用价值。方法:通过回顾性研究我院近年来结直肠癌术后切口疝患者疝修补方式,比较生物补片联合自身腹膜折叠修补方式与传统无张力修补两种手术方式的优劣。结果:二组患者手术时间、术中出血量、住院时间无差异,无统计学意义;生物补片联合自身腹膜折叠修补组患者在术后总引流量、切口液化感染、术后慢性疼痛及疝复发率上明显低于传统无张力修补组,差异有统计学意义(P<0.05)。结论:生物补片联合自身腹膜折叠修补巨大腹壁切口疝能有效减少患者切口感染,减少术后慢性疼痛及疝再发的发生率,是一项值得在基层医院推广的新技术。

Objective： To evaluate the clinical effects of repairing the huge abdominal incisional hernia with biological patch and autogeneic peritoneal flap hernoplasty. Methods： The clinical data were retrospectively examined in 55 colorectal caner patients complicated with postoperative incisional hernia undergone either combined biological patch with autogeneic peritoneal flap hernoplasty（ Group B） or conventional tensin-free hernia repair（ Group A） in our hospital between Feb. 2001 and Dec. 2013. Results： The two groups were not statistically different regarding the operative time,intraoperative blood loss and hospital stay,yet group B had lower total drainage volume,fewer incidences of fat liquefaction and incision infection as well as reduced postoperative chronic pain and relapsed incisional hernia,and the difference was significant（ P〈0. 05）. Conclusion： Application of biological patch and autogeneic peritoneal flap to repairing huge abdominal incisional hernias may effectively reduce the wound infection,postoperative chronic pain and the incidence of recurrent hernia,suggesting that this technique can be wider recommendation in basic-level hospitals.