Concomitant enterostomy closure and ventral abdominal wall reconstruction using the Lázaro da Silva technique

R. M. Melo, Pedro Ducatti Oliveira-e-Silva, E. Oliveira
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Abstract

We present a small series of patients who underwent concomitant treatment of external digestive bypass (stoma) and incisional hernia, using the Lazaro da Silva technique - a special method of purely tissue repair. The rational was not to use meshes on contaminated wounds. Initially, five patients were enrolled and all were operated on by the same group. Some demographic data were recorded, but also the time interval between the making of the stoma (or the appearance of the enterocutaneous fistula). Some characteristics of the hernia and data related to surgical procedures were also pointed out. The primary outcome was to verify the rate of hernial recurrence, but also the surgical site occurrences in the first 30 days. Only one patient had superficial wound infection and in none of them was a recurrence detected. Our work raises some questions about the best approach in these more complex cases, such as dissociating or not dissociating the procedures, the use of meshes anyway, and employment of mini-invasive surgery in some steps.
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使用Lázaro da Silva技术进行肠造口闭合和腹壁重建
我们介绍了一小部分患者,他们使用Lazaro da Silva技术(一种纯组织修复的特殊方法)接受了外部消化搭桥(造口)和切口疝的同时治疗。合理的做法是不要在污染的伤口上使用网格。最初,5名患者被招募,所有患者都由同一组进行手术。记录了一些人口统计学数据,但也记录了造口(或肠皮瘘的出现)之间的时间间隔。本文还指出了疝的一些特点和与外科手术有关的资料。主要结果是验证疝复发率,以及手术部位在前30天的发生率。仅有1例患者有浅表伤口感染,且均未发现复发。我们的工作提出了一些关于在这些更复杂的情况下的最佳方法的问题,例如分离或不分离手术,无论如何使用网格,以及在某些步骤中使用微创手术。
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