疝区腹膜折叠法修复巨大腹壁疝

Repeated Doubling Peritoneum to Repair Huge Abdominal Wall Hernia

目的:提出一种修复数次术后复发的巨大腹壁疝的有效方法。方法:利用巨大腹壁疝多余的囊壁组织即腹膜,切开后提起,在缺损区双侧自基底部反复折叠缝合,形成-5～7层的条索状腹膜组织,以加固缺损区。结果:所形成的条索状的腹膜组织具生物活性且坚韧性强,经对10例多次术后复发的巨大腹壁疝病人的修复后随访,无一例复发。结论:此法原位取材、简便牢靠,既避免了使用阔筋膜游离移植存在的异位创伤、供区有限及并发肌疝等问题,又避免了单纯使用合成材料所面临的排斥反应及感染松脱的问题,是目前较为理想的一种疝修复方法。

Objective: The article raises an effective method to repair the huge abdominal wall hernia of repeated post - operative recurrence.Method:The patients' huge abdominal wall hernia which have sufficient hernial wall,namely,peritoneum can be used. We incise and raise the peritoneum from the baseline,suture repeated at the bilateral hernial space so that it forms as-7 layers thick and cord - like peritoneal tissue to intensify the lesion area. Results: The thick and cord - like peritoneal tissue is more powerful and flexible and has more biological activity man a layer free fascia latea 10 patients, who suffered from huge abdominal wall hernia of repeated post- operative recurrence, have been repaired with this method. 1 to 10 years follow-up found no recurrence. Conclusion: The method,which uses original abdominal peritoneum to intensify the lesion area,is simple and effective. It can avoid the problem of trauma in other position, complications of muscular hernia by using the free fascia latea and the problem of rejection episode, inflammation and loose by only using the synthetic meterial. It is an optimal means for repairing the huge abdominal wall hernia at present.