不同的腹部缝合技术对高危患者的初次缝合是否有优势?

M. Dinçer, E. Aygen
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摘要

切口疝因其高发病率和高致残率一直是外科手术的主要问题之一。本研究的目的是比较不同的修复技术与初级修复技术对切口疝的风险。材料和方法:本研究纳入腹部中线切口的高危患者。患者分为四组。每组20例。第一组患者行一期修复手术。第二组采用Cardiff修复技术。第三组采用龙骨法修复。第4组采用嵌片法修复。术后第一年每3个月随访一次,术后两年每6个月随访一次。记录切口疝、发生时间及其他并发症。结果:本研究纳入了80例切口疝高危患者。其中女性占47.5%,男性占52.5%。患者平均年龄59.2±12.95岁。平均住院时间8.5天(4 ~ 28天)。平均随访18个月(6 ~ 34个月)。4例(5%)患者出现复发。第1组有15%的患者复发,第2组有5%的患者复发。其他组无复发。两组间切口疝及其他并发症发生率差异无统计学意义(p = 0.368)。结论:两种术式在切口疝的发生及并发症方面无显著差异。
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Is there any superiority of the different abdominal closure techniques for primary closure in high-risk patients?
Introduction: Incisional hernia continues to be one of the major problems of surgery due to its high incidence rate and high morbidity. The aims of this study are to compare different repair techniques with primary repair techniques for the risk of incisional hernia. Material and methods: High-risk patients who had a midline incision of the abdomen were included in this study. Patients were divided into four groups. Each group contained 20 patients. Patients of group 1 were operated on using primary repair. In group 2 Cardiff repair technique was used. The patients in group 3 were repaired with Keel technique. The patients of group 4 were repaired with onlay technique. Patients were followed up with physical examination at 3-month periods in the first year after surgery and 6-month periods in the following two years. Incisional hernia, occurrence time and other complications were noted. Results: Eighty patients who had high risk of incisional hernia were included in this study. 47.5% of them were female and 52.5% of them were male. The average age of patients was 59.2 ±12.95. Average hospitalization time was 8.5 days (4–28 days). Average follow-up was 18 months (6–34 months). In total 4 (5%) patients had recurrence. Fifteen percent of patients in group 1 had recurrence and 5% of patients in group 2 had recurrence. There was no recurrence in other groups. There was no significant difference for incisional hernia and the other complications between groups (p = 0.368). Conclusions: There was no significant difference between the techniques in terms of the development of incisional hernias or complications.
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