人工补片修补腹壁巨大复杂切口疝和缺损(附112例报道)

Repair of massive and complex incisional hernia or defect of abdominal wall by using prosthetic mesh(Report of 112 cases)

目的评价人工补片修补腹壁巨大复杂切口疝或缺损的效果。方法对解放军总医院第一附属医院2003年2月至2016年2月期间收治的112例腹壁巨大复杂切口疝或缺损患者的临床资料进行回顾性分析。结果采用肌后腹膜前放置补片修补63例,开腹腹膜内放置补片修补49例。108例患者术后切口一期愈合,4例发生切口感染,7例发生血清肿。39例患者术后近期修补区有牵拉感,17例有轻度疼痛。获得随访者102例,随访时间9~156个月(平均78.6个月),复发3例,复发率为2.94%。结论人工补片修补腹壁巨大复杂切口疝或缺损疼痛轻,恢复快,复发率低。

Objective To evaluate effect of massive and complex incisional hernia or defect of abdominal wall by using prosthetic mesh. Method The clinical data of 112 patients with massive and complex incisional hernia or defect of abdominal wall from February 2003 to February 2016 were analyzed retrospectively. Results Sixty-three cases were repaired by placing artificial mesh between the peritoneum and the musculus rectus abdominis and 49 cases by opening intraperitoneal mesh placement. The primary healing occurred in 108 cases, the incision infection occured in 4 cases, the seroma occurred in 7 cases. The stretched feeling was found in 39 cases and the mild pain occurred in 17 cases in the operative area at early term after operation. One hundred and two patients were followed up for 9-156 months （mean 78.6 months）, the recurrence was observed in 3 cases （2.94%）. Conclusion Repair of massive and complex incisional hernia or defect of abdominal wall by using prosthetic mesh has some advantages of minimal invasiveness, rapid convalescence, and low recurrent rate.