PDF(Pubmed)
Abstract：
Aim Giant incisional herniae are larger than 15 cm and are typically treated with an open approach. Our aim was to highlight the outcomes of treating giant incisional hernia using open intraperitoneal dual mesh. Methods Between January 2015 and December 2021, 25 patients with giant incisional hernias, where fascial defects were 15-30 cm, were evaluated retrospectively. Intraperitoneal dual mesh was used in all patients. The patients were evaluated in terms of age, gender, body mass index (BMI), previous abdominal surgeries, defect diameter, anesthesia method, length of hospital stay, drain application, complications, and recurrence. Results Eleven of the patients were male and 14 were female. The mean age was 62±13.5 years (29-82 years). The average BMI was 32 kg/m2 (20-52 kg/m2). The mean size of the fascial defect was 22±5.5 cm (15-30). The mean operation time was 90 minutes (70-130 minutes). Six patients had type I and II complications according to the Clavien-Dindo classification, specifically superficial skin infections, skin erosion, subcutaneous bleeding, and temporary ileus due to intestinal adhesion. During the average follow-up period of 36 months (6-70 months), no major complications were observed related to the recurrence and use of dual mesh. Conclusion In the treatment of giant incisional hernia, open intraperitoneal dual mesh application should be kept in mind as an effective treatment option with low complication and recurrence rates.
摘要：
目的巨大切口疝大于15厘米，通常采用开放方法治疗。我们的目的是强调使用开放式腹膜内双网片治疗巨大切口疝的结果。方法2015年1月至2021年12月,25例巨大切口疝患者,筋膜缺损15-30厘米，进行回顾性评估。所有患者均采用腹膜内双网片。对患者进行了年龄评估，性别,体重指数（BMI），以前的腹部手术，缺陷直径,麻醉方法,住院时间,排水应用,并发症,和复发。结果男性11例,女性14例。平均年龄为62±13.5岁（29-82岁）。平均BMI为32kg/m2(20-52kg/m2)。筋膜缺损的平均大小为22±5.5cm（15-30）。平均手术时间为90分钟（70-130分钟）。根据Clavien-Dindo分类，6例患者有I型和II型并发症，特别是浅表皮肤感染，皮肤糜烂,皮下出血,和肠粘连引起的暂时性肠梗阻。平均随访36个月(6-70个月),未观察到与复发和使用双网孔相关的主要并发症。结论在巨大切口疝的治疗中,应牢记开放式腹膜内双网状应用是一种有效的治疗选择，并发症和复发率低。
