巨大切口疝的开放式无张力修补术

目的:总结无张力技术修补巨大切口疝的临床经验及其围手术期处理要点.方法:对我院2002年5月至2007年5月收治的38例巨大切口疝临床资料进行回顾性分析,其中30例应用肌后修补法(sublay法)修补,8例采用腹腔内补片修补法(underlay法)修补,所用补片材料为聚丙烯(68.0%)或复合补片(32%).随访1～5年,统计病人的并发症和复发率.结果:80%病人有术前合并症,包括肥胖(45%)、糖尿病(16.4%)、慢性阻塞性肺疾病(12.5%)和腹主动脉瘤(2.7%).无张力疝修补后2～3周病人均痊愈出院.随访结果,复发2例(5.3%),伤口感染3例(7.9%),血清肿5例(13.1%).结论:人工材料无张力修补术是治疗腹壁大切口疝的优良术式,手术创伤小、术后恢复快.对于疝环巨大或疝内容物多、突出时间长的特大切口疝病人应给予充分的术前准备.

Open tension-free repair with prosthetic mesh for giant incisional abdominal hernia

Objective To summarize the clinical experience of the tension-free technique in abdominal giant incisional hernia(AGIH) repair,and its perioperative management.Methods During the period from May 2002 to May 2007,73 patients underwent prosthetic mesh repair for abdominal incisional hernia;among which,30 cases underwent sublay repair and 8 cases underwent underlay repair.Polypropylene meshes were used in 68%of the cases and compound meshes in 32%.Results Eighty percent of the patients had concomitant diseases...