腹膜腱膜瓣加强补片修补技术用于腹壁切口疝手术158例报告

Clinical analysis on the flap reinforcement of abdominal wall with“envelopped”mesh technique in 158 incisional hernia cases

目的探讨腹膜腱膜瓣加强补片修补(FRAEM)技术在腹壁切口疝手术中的应用价值。方法回顾性分析2017年9月至2020年6月复旦大学附属华东医院收治的158例采用FRAEM技术进行修补手术的腹壁切口疝病人的临床资料,观察围手术期及随访期内的指标,分析疗效。结果158例病人均顺利完成手术,手术时间86~116(118.3±21.6)min,住院时间3~79(8.2±1.7)d。住院期间出现并发症12例,其中1例肠瘘,2例术后切口感染,8例出现血清肿,1例血肿;术后随访3~36个月,8例出现并发症,其中1例补片感染,2例慢性疼痛,4例腹壁膨出,1例病人复发。结论采用FRAEM技术行腹壁切口疝修补手术疗效确切,术后恢复时间较短,中短期内并发症发生率低,值得在临床进一步推广应用。

Objective To analyze the application value of the FRAEM technique in incisional hernia patients.Methods The clinical data of 158 patients with incisional hernia treated through the FRAEM technique from September 2017 to June 2020 in Huadong Hospital Affiliated to Fudan University were analyzed retrospectively.The observing indicators during perioperative and follow-up periods were analyzed to explore the application value and treatment experience of the novel technique.Results The average operation time was(118.3±21.6)min and the average hospital stay was(8.2±1.7)d.There were 12 cases of complications during hospitalization,including 1 case of intestinal fistula,2 cases of postoperative surgical-site infection,8 cases of seroma and 1 case of hematom.After 3 to 36 months of followup,there were 8 cases of complications,1 case of recurrence,1 case of patch infection,2 cases of chronic pain,and 4 cases of abdominal wall bulging.Conclusion FRAEM technique is effective in the treatment of incisional hernias,with shorter postoperative recovery time and lower incidence of complications in the short and medium term,which is worthy of further clinical application.