疝与腹壁外科现状与修补材料创新研究发展

Current status of hernia and abdominal wall surgery and innovation research and development of repairing materials

近年来，我国疝与腹壁外科快速发展。腹股沟疝、腹壁切口疝无张力修补术已普及，腹腔镜甚至达芬奇机器人手术系统疝修补术也正迅速推广。由于国内各地区经济和医疗水平发展不均衡，不规范诊断与治疗仍存在。疝与腹壁外科注册登记系统和质量控制标准亟待建立。全世界疝与腹壁外科基础研究仍较薄弱，目前国际上已有少数病因学、遗传学和分子流行病学相关研究报道，疝的具体病因、遗传方式值得深入探讨。疝与腹壁外科进步离不开修补材料发展。目前修补材料主要包括合成材料和生物材料两大类。尽管补片疝修补术可降低术后复发率，但远期补片相关不良事件不容忽视，常见的包括补片皱缩和移位、组织侵蚀和粘连、补片感染等。目前尚无绝对理想的修补材料，但材料学新研究发展值得疝与腹壁外科医师期待。

Nowadays, hernia and abdominal wall surgery developes rapidly in China. Tension-free repair for inguinal hernia and abdominal wall incisional hernia is popular, and laparoscopic and even Da Vinci robotic hernia repair have been promoted rapidly. Due to the unbalanced development in different areas of China, there is still existence of irregular diagnosis and treatment in hernia. Registry system of hernia and abdominal wall surgery and quality control standards are urgently needed. A few etiology, genetics and molecular epidemiology studies have been reported, although basic research of hernia is weak in the whole world. The exact pathogenesis and inheritance pattern are worthy of further study. The progress of hernia and abdominal surgery is inseparable from the development of repairing materials.At present, the repairing materials are mainly composed of synthetic materials and biomaterials. Although prosthetic repair can reduce postoperative hernia recurrence rate, mesh related adverse events in the long term should not be ignored, including common complications such as mesh shrinkage, erosion, adhesion, infection and so on. There is no ideal repairing material yet, but the innovative research and development of materials is worthy of the expectation in hernia and abdominal wall surgeons.