• 解放軍總醫(yī)院第一附屬醫(yī)院普外科( 北京 100048);

目的  總結(jié)腹壁切口疝補(bǔ)片修補(bǔ)術(shù)后復(fù)發(fā)再次手術(shù)治療的經(jīng)驗(yàn)。
方法  回顧性分析我院2007年1月至2010年12月期間收治的16例腹壁切口疝補(bǔ)片修補(bǔ)術(shù)后復(fù)發(fā)再次手術(shù)患者的資料。
結(jié)果  所有患者均再次采用補(bǔ)片進(jìn)行修補(bǔ),其中13例除去舊補(bǔ)片置入新補(bǔ)片修補(bǔ),2例新補(bǔ)片與原補(bǔ)片重疊并擴(kuò)大范圍修補(bǔ),1例在原補(bǔ)片上直接重疊新補(bǔ)片修補(bǔ)。術(shù)后所有患者切口均Ⅰ期愈合,3例發(fā)生補(bǔ)片上方積液,經(jīng)穿刺加壓后治愈。術(shù)后住院時(shí)間7~16d,平均9d。術(shù)后引流管拔除時(shí)間2~7d,平均4d。所有患者均獲隨訪,隨訪時(shí)間5~36個(gè)月,平均20個(gè)月,1例有輕微腹壁異物感,無修補(bǔ)區(qū)慢性疼痛,無疝復(fù)發(fā)。
結(jié)論  補(bǔ)片修補(bǔ)術(shù)后復(fù)發(fā)性切口疝再次手術(shù)時(shí)需綜合考慮復(fù)發(fā)疝的位置以及既往選用的補(bǔ)片類型和修補(bǔ)方法,再次手術(shù)需選用合適的補(bǔ)片及修補(bǔ)方法方可取得滿意效果。

引用本文: 劉飛德,王世斌,朱瑛梅,姚勝,裴利娟,李基業(yè). 腹壁切口疝補(bǔ)片修補(bǔ)術(shù)后復(fù)發(fā)的再手術(shù)治療. 中國(guó)普外基礎(chǔ)與臨床雜志, 2012, 19(3): 300-304. doi: 復(fù)制

1. Langer C, Neufang T, Kley C, et al. Central mesh recurrence after incisional hernia repair with Marlex—— are the meshes strong enough? [J]. Hernia, 2001, 5(3): 164-167.
2. Jansen PL, Mertens PR, Klinge U, et al. The biology of hernia formation [J]. Surgery, 2004, 136(1): 1-4.
3. Abdollahi A, Maddah GH, Mehrabi BM, et al. Prosthetic incisional hernioplasty: clinical experience with 354 cases [J].Hernia, 2010, 14(6): 569-573.
4. Sanchez VM, Abi-Haidar YE, Itani KM. Mesh infection in ventral incisional hernia repair: incidence, contributing factors,and treatment [J]. Surg Infect (Larchmt), 2011, 12(3): 205-210.
5. Liu F, Li J. Repair of large abdominal wall defects using the Proceed? surgical mesh with open intra-peritonium onlay method [J]. Saudi Med J, 2011, 32(5): 504-509.
6. Tong WM, Hope W, Overby DW, et al. Comparison of outcome after mesh-only repair, laparoscopic component separation, and open component separation [J]. Ann Plast Surg, 2011, 66(5):551-556.
7. Martin DF, Williams RF, Mulrooney T, et al. Ventralex mesh in umbilical/epigastric hernia repairs: clinical outcomes and complications [J]. Hernia, 2008, 12(4): 379-383.
8. Steinhagen E, Khaitov S, Steinhagen RM. Intraluminal 中國(guó)普外基礎(chǔ)與臨床雜志2012 年3 月第19 ? 304 ? 卷第3 期 Chin J Bases Clin General Surg, Vol. 19, No. 3, Mar. 2012migration of mesh following incisional hernia repair [J]. Hernia,2010, 14(6): 659-662.
9. Stremitzer S, Bachleitner-Hofmann T, Gradl B, et al. Mesh graft infection following abdominal hernia repair: risk factor evaluation and strategies of mesh graft preservation. A retrospective analysis of 476 operations [J]. World J Surg, 2010, 34(7): 1702-1709.
10. Tolino MJ, Tripoloni DE, Ratto R, et al. Infections associated with prosthetic repairs of abdominal wall hernias: pathology,management and results [J]. Hernia, 2009, 13(6): 631-637.
11. Andersen LP, Klein M, Gögenur I, et al. Long-term recurrence and complication rates after incisional hernia repair with the open onlay technique [J]. BMC Surg, 2009, 9(1): 6.
12. Falagas ME, Kasiakou SK. Mesh-related infections after hernia repair surgery [J]. Clin Microbiol Infect, 2005, 11(1): 3-8.
13. Burger JW, Halm JA, Wijsmuller AR, et al. Evaluation of new prosthetic meshes for ventral hernia repair [J]. Surg Endosc,2006, 20(8): 1320-1325.
14. Adotey JM. Incisional hernia: a review[J]. Niger J Med,2006,15(1): 34-43.
15. Stoppa R. About prosthetic repair and contaminated areas [J].Hernia, 2005, 9(1): 107-108.
16. Höer J, Lawong G, Klinge U, et al. Factors influencing the development of incisional hernia. A retrospective study of 2 983 laparotomy patients over a period of 10 years [J]. Chirurg,2002, 73(5): 474-480.
17. Schumpelick V, Conze J, Klinge U. Preperitoneal mesh-plasty in incisional hernia repair. A comparative retrospective study of 272 operated incisional hernias [J]. Chirurg, 1996, 67(10): 1028-1035.
18. Amid PK, Shulman AG, Lichtenstein IL, et al. Biomaterials for abdominal wall hernia surgery and principles of their applications [J]. Langenbecks Arch Chir, 1994, 379(3): 168-171.
19. Gray SH, Vick CC, Graham LA, et al. Variation in mesh placement for ventral hernia repair: an opportunity for process improvement? [J]. Am J Surg, 2008, 196(2): 201-206.
20. Schumpelick V, Klinge U, Junge K, et al. Incisional abdominal hernia: the open mesh repair [J]. Langenbecks Arch Surg,2004, 389(1): 1-5.
21. Flum DR, Horvath K, Koepsell T. Have outcomes of incisional hernia repair improved with time? A population-based analysis [J]. Ann Surg, 2003, 237(1): 129-135.
22. Bower CE, Reade CC, Kirby LW, et al. Complications of laparoscopic incisional-ventral hernia repair: the experience of a single institution [J]. Surg Endosc, 2004, 18(4): 672-675.
23. Uranues S, Salehi B, Bergamaschi R. Adverse events, quality of life, and recurrence rates after laparoscopic adhesiolysis and recurrent incisional hernia mesh repair in patients with previous failed repairs [J]. J Am Coll Surg, 2008, 207(5): 663-669.
24. Tsimoyiannis EC, Siakas P, Glantzounis G, et al. Seroma in laparoscopic ventral hernioplasty [J]. Surg Laparosc Endosc Percutan Tech, 2001, 11(5): 317-321.
25. Malik AM, Jawaid A, Talpur AH, et al. Mesh versus nonmesh repair of ventral abdominal hernias [J]. J Ayub Med Coll Abbottabad, 2008, 20(3): 54-56.
  1. 1. Langer C, Neufang T, Kley C, et al. Central mesh recurrence after incisional hernia repair with Marlex—— are the meshes strong enough? [J]. Hernia, 2001, 5(3): 164-167.
  2. 2. Jansen PL, Mertens PR, Klinge U, et al. The biology of hernia formation [J]. Surgery, 2004, 136(1): 1-4.
  3. 3. Abdollahi A, Maddah GH, Mehrabi BM, et al. Prosthetic incisional hernioplasty: clinical experience with 354 cases [J].Hernia, 2010, 14(6): 569-573.
  4. 4. Sanchez VM, Abi-Haidar YE, Itani KM. Mesh infection in ventral incisional hernia repair: incidence, contributing factors,and treatment [J]. Surg Infect (Larchmt), 2011, 12(3): 205-210.
  5. 5. Liu F, Li J. Repair of large abdominal wall defects using the Proceed? surgical mesh with open intra-peritonium onlay method [J]. Saudi Med J, 2011, 32(5): 504-509.
  6. 6. Tong WM, Hope W, Overby DW, et al. Comparison of outcome after mesh-only repair, laparoscopic component separation, and open component separation [J]. Ann Plast Surg, 2011, 66(5):551-556.
  7. 7. Martin DF, Williams RF, Mulrooney T, et al. Ventralex mesh in umbilical/epigastric hernia repairs: clinical outcomes and complications [J]. Hernia, 2008, 12(4): 379-383.
  8. 8. Steinhagen E, Khaitov S, Steinhagen RM. Intraluminal 中國(guó)普外基礎(chǔ)與臨床雜志2012 年3 月第19 ? 304 ? 卷第3 期 Chin J Bases Clin General Surg, Vol. 19, No. 3, Mar. 2012migration of mesh following incisional hernia repair [J]. Hernia,2010, 14(6): 659-662.
  9. 9. Stremitzer S, Bachleitner-Hofmann T, Gradl B, et al. Mesh graft infection following abdominal hernia repair: risk factor evaluation and strategies of mesh graft preservation. A retrospective analysis of 476 operations [J]. World J Surg, 2010, 34(7): 1702-1709.
  10. 10. Tolino MJ, Tripoloni DE, Ratto R, et al. Infections associated with prosthetic repairs of abdominal wall hernias: pathology,management and results [J]. Hernia, 2009, 13(6): 631-637.
  11. 11. Andersen LP, Klein M, Gögenur I, et al. Long-term recurrence and complication rates after incisional hernia repair with the open onlay technique [J]. BMC Surg, 2009, 9(1): 6.
  12. 12. Falagas ME, Kasiakou SK. Mesh-related infections after hernia repair surgery [J]. Clin Microbiol Infect, 2005, 11(1): 3-8.
  13. 13. Burger JW, Halm JA, Wijsmuller AR, et al. Evaluation of new prosthetic meshes for ventral hernia repair [J]. Surg Endosc,2006, 20(8): 1320-1325.
  14. 14. Adotey JM. Incisional hernia: a review[J]. Niger J Med,2006,15(1): 34-43.
  15. 15. Stoppa R. About prosthetic repair and contaminated areas [J].Hernia, 2005, 9(1): 107-108.
  16. 16. Höer J, Lawong G, Klinge U, et al. Factors influencing the development of incisional hernia. A retrospective study of 2 983 laparotomy patients over a period of 10 years [J]. Chirurg,2002, 73(5): 474-480.
  17. 17. Schumpelick V, Conze J, Klinge U. Preperitoneal mesh-plasty in incisional hernia repair. A comparative retrospective study of 272 operated incisional hernias [J]. Chirurg, 1996, 67(10): 1028-1035.
  18. 18. Amid PK, Shulman AG, Lichtenstein IL, et al. Biomaterials for abdominal wall hernia surgery and principles of their applications [J]. Langenbecks Arch Chir, 1994, 379(3): 168-171.
  19. 19. Gray SH, Vick CC, Graham LA, et al. Variation in mesh placement for ventral hernia repair: an opportunity for process improvement? [J]. Am J Surg, 2008, 196(2): 201-206.
  20. 20. Schumpelick V, Klinge U, Junge K, et al. Incisional abdominal hernia: the open mesh repair [J]. Langenbecks Arch Surg,2004, 389(1): 1-5.
  21. 21. Flum DR, Horvath K, Koepsell T. Have outcomes of incisional hernia repair improved with time? A population-based analysis [J]. Ann Surg, 2003, 237(1): 129-135.
  22. 22. Bower CE, Reade CC, Kirby LW, et al. Complications of laparoscopic incisional-ventral hernia repair: the experience of a single institution [J]. Surg Endosc, 2004, 18(4): 672-675.
  23. 23. Uranues S, Salehi B, Bergamaschi R. Adverse events, quality of life, and recurrence rates after laparoscopic adhesiolysis and recurrent incisional hernia mesh repair in patients with previous failed repairs [J]. J Am Coll Surg, 2008, 207(5): 663-669.
  24. 24. Tsimoyiannis EC, Siakas P, Glantzounis G, et al. Seroma in laparoscopic ventral hernioplasty [J]. Surg Laparosc Endosc Percutan Tech, 2001, 11(5): 317-321.
  25. 25. Malik AM, Jawaid A, Talpur AH, et al. Mesh versus nonmesh repair of ventral abdominal hernias [J]. J Ayub Med Coll Abbottabad, 2008, 20(3): 54-56.