复合补片修补腹壁肿瘤切除后巨大腹壁缺损的临床疗效

目的探讨复合补片修补腹壁肿瘤切除后巨大腹壁缺损的临床疗效。 方法回顾性分析2015年2月至2017年8月，新疆医科大学第四附属医院收治的55例腹壁肿瘤切除术后巨大腹壁缺损患者临床资料，根据植入补片的不同分为试验组（35例）和对照组（20例），2组患者均行腹壁肿瘤切除术，试验组植入Proceed补片，对照组植入Composix Kugel补片。比较2组手术相关临床参数、手术前后不同时间疼痛程度、切口愈合情况、并发症、肿瘤复发及转移情况。 结果2组铺置补片时间及术后自主活动时间比较，差异无统计学意义（P>0.05）。术后12 h至7 d，2组患者视觉模拟评分均呈逐渐降低趋势，且均明显低于术前（P<0.05），但2组间均无明显差异（P>0.05）。拆线后伤口均达到一期愈合，2组总并发症发生率比较，差异无统计学意义（P>0.05）。随访1年，试验组肿瘤原位复发1例，对照组肿瘤远处转移1例，2组患者腹壁修复材料腹腔面光滑，且均未见腹壁修复材料与肠管黏连。 结论采用Proceed补片和Composix Kugel补片对腹壁肿瘤切除后巨大腹壁缺损进行修复和重建，效果均较好，安全性高。

Clinical effect of composite mesh for repairing massive abdominal wall defect after abdominal wall tumor resection

ObjectiveTo explore the clinical effect of composite mesh for repairing massive abdominal wall defect after abdominal wall tumor resection. MethodsThe clinical data of 55 patients with massive abdominal wall defect after abdominal wall tumor resection in the Fourth Affiliated Hospital of Xinjiang Medical University from February 2015 to August 2017 were retrospectively analyzed, they were divided into the experiment group (n=35) and the control group (n=20) according to the different mesh implanted. The two groups underwent abdominal wall tumor resection, the experiment group was implanted with Johnson Proceed mesh, the control group was implanted with Bard Composix Kugel mesh. The clinical parameters, pain degree at different time before and after surgery, the situation of healing of the incision, complications, tumor recurrence and metastasis in the two groups were compared. ResultsThere was no significant difference in time of implanting mesh and postoperation spontaneous activity time between the two groups (P>0.05). The visual analogue score (VAS) from 12 hours to 7 days of postoperation gradually decreased in the two groups (P<0.05), and which were significantly lower than of preoperation (P<0.05), but there was no significant difference between the two groups (P>0.05). After suture removed, the wounds all reached the first stage of healing, there was no significant difference in the incidence of total complications between the two groups (P>0.05). The follow-up period was 1 year, there was one case of tumor recurrence in the experiment group, one case of distant metastasis in the control group. The abdominal wall repair material was smooth, and no adhesion between the abdominal wall repair material and the intestinal tube was observed in the two groups. ConclusionThe clinical effect of restoration and reconstruction of massive abdominal wall defect after abdominal wall tumor resection using Johnson Proceed mesh or Bard Composix Kugel mesh is good and safety.