腹壁巨大切口疝修补术的治疗现状

Current Status of Hernia Repair with Huge Abdominal Incision

腹壁切口疝是腹部手术后常见的并发症之一,手术修补是唯一有效的治疗方式。根据最新指南定义巨大切口疝是指腹壁缺损最大直径 > 12 cm或疝囊容积与腹腔容积比 > 20% (不论其腹壁缺损最大径为多少),随着巨大切口疝发病率的逐年增长,手术方式也在不断改变,但没有像小、中、大切口疝那样统一的手术方式。现代疝外科更注重“微创”和“腹壁功能重建”,在修复腹壁缺损、恢复腹壁功能的同时,尽可能减少腹壁的过度分离。随着新材料的研发、新技术的探索和腔镜平台的升级换代,基于微创理念的腹腔切口疝修补术会拥有更广阔的前景。

Abdominal incisional hernia is one of the common complications after abdominal surgery. Surgical repair is the only effective treatment. According to the latest guidelines, giant incisional hernia is defined as the maximum diameter of the abdominal wall defect > 12 cm or the ratio of the volume of the hernia sac to the abdominal cavity > 20% (regardless of the maximum diameter of the ab-dominal wall defect). With the increase of the incidence of giant incisional hernia year by year, the surgical methods are constantly changing, but there is no unified surgical methods like small, me-dium and large incisional hernia. Modern hernia surgery pays more attention to “minimally inva-sive” and “abdominal wall function reconstruction”, which can repair abdominal wall defects and restore abdominal wall function while minimizing excessive separation of the abdominal wall. With the development of new materials, the exploration of new technologies and the upgrading of endo-scopic platforms, the ventral/incisional hernia repair based on the minimally invasive concept will witness a more promising future.