单中心回顾性分析腹中线切口疝置入式与置入式聚丙烯网片修复术后的早期疗效。

IF 0.8 Q4 SURGERY Chirurgia Pub Date : 2023-12-01 DOI:10.21614/chirurgia.2023.v.118.i.6.p.673
Petre Vh Bot Ianu, Flavian Tutuianu, Cristina Radoi, Emmanuel Ladanyi, Ana Maria V
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引用次数: 0

摘要

背景:在中线切口疝的开放式修补术中,最常用的方法是粘贴和肌下粘贴网片修补术。粘贴式网片修复术操作简单、快速,而肌层下网片修复术则提供了防止感染的辅助保护,但它被认为是一种更为复杂的手术,术后早期并发症的风险较高。外科医生的个人经验在选择网片放置技术时起着重要作用:本文介绍了对 2017 年 1 月 31 日至 2019 年 12 月 31 日期间在罗马尼亚 Mures 临床县医院外科诊所接受腹中线切口疝亚层或嵌体聚丙烯网片修补术的 220 名连续患者的回顾性分析结果。根据网片的位置将患者分为两组。两组患者在年龄、性别分布、合并症(肥胖、糖尿病、心脏和呼吸系统疾病)发生率、既往手术次数和缺损大小方面均相同(所有参数的 P 值均为 0.05)。结果显示术后死亡率为零,两组患者术后住院时间差异无统计学意义(P 0.05)。因血肿、皮肤坏死、血清肿、伤口化脓和肠梗阻而需要进行的早期再手术共有 34 例,两组之间的差异无统计学意义(每种并发症的总发生率和单独发生率均为 0.05)。镶嵌式放置网片与较晚拔除浅表引流管有关(A 组 2/62 对 B 组 141/168,P0.0001),较大比例的患者在出院时未拔除引流管。结论在中线切口疝的治疗中,无论是粘贴还是肌下粘贴聚丙烯网,都能取得良好的效果。肌后皮下修复术后没有出现早期并发症,这就说明应更多地使用这种技术,因为它能起到预防感染的辅助作用。
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Early Outcome after Sublay versus Onlay Polypropylene Mesh Repair for Ventral Midline Incisional Hernia - A Single Center Retrospective Analysis.

Context: Onlay and retromuscular sublay mesh repairs are the most frequently used procedures in open repair of midline incisional hernias. The onlay placement of the mesh is simple and fast to perform, while the sublay retromuscular repair offers a supplementary protection against infection, but it is considered a more complicated procedure with a higher risk of early postoperative complications. The personal experience of the surgeons plays an important role in choosing the technique of mesh placement.

Material and methods: This paper presents the results of a retrospective analysis of 220 consecutive patients operated on in the Surgical Clinic of the Mures Clinical County Hospital (Romania) between 31.01.2017 - 31.12.2019 with sublay or onlay polypropylene mesh repair for ventral midline incisional hernia. The patients were divided into two groups according to the position of the mesh. The two groups were identical in terms of age, sex distribution, incidence of comorbidities (obesity, diabetes mellitus, cardiac and respiratory diseases), number of previous operations and size of the defect (p value 0.05 for all the parameters). Results: Postoperative mortality was zero, with no statistically significant differences of the duration of the postoperative hospitalization between the two groups p 0.05. A total of 34 early reoperations were required for hematoma, skin necrosis, seroma, wound suppuration, and intestinal obstruction, with no statistically significant difference between the two groups (p 0.05 for the overall and separate incidence of each complication). The onlay placement of the mesh was associated with a later removal of the superficial drains p 0.0001 with a larger proportion of the patients who were discharged without removing the drains (group A 2/62 versus group B 141/168, p 0.0001). Conclusions: Both the onlay and the retromuscular sublay placement of polypropylene meshes may be used with good results for the treatment of midline incisional hernias. The lack of a supplementary early morbidity after the retromuscular sublay repair is an argument for a more frequent use of this technique which offers a supplementary protection against infection.

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来源期刊
Chirurgia
Chirurgia Medicine-Surgery
CiteScore
1.00
自引率
0.00%
发文量
75
审稿时长
4-8 weeks
期刊介绍: Chirurgia is a bimonthly journal. In Chirurgia, original papers in the area of general surgery which neither appeared, nor were sent for publication in other periodicals, can be published. You can send original articles, new surgical techniques, or comprehensive general reports on surgical topics, clinical case presentations and, depending on publication space, - reviews of some articles of general interest to surgeons from other publications. Chirurgia is also a place for sharing information about the activity of various branches of the Romanian Society of Surgery, information on Congresses and Symposiums organized by the Romanian Society of Surgery and participation notes in other scientific meetings. Letters to the editor: Letters commenting on papers published in Chirurgia are welcomed. They should contain substantive ideas and commentaries supported by appropriate data, and should not exceed 2 pages. Please submit these letters to the editor through our online system.
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