Abstract:
Management of obstetrical and gynecologic patients with hernias poses challenges to providers. Risks for hernia development include well-described factors that impair surgical wound healing and increase abdominal pressure. Among the diverse populations cared for by obstetricians and gynecologists, pregnant patients and those with gynecologic malignancies are at the highest risk for hernia formation. This article provides an overview of the existing literature, with a focus on patients cared for by obstetrician-gynecologists and commonly encountered preoperative and intraoperative scenarios. We highlight scenarios when a hernia repair is not commonly performed, including those of patients undergoing nonelective surgeries with known or suspected gynecologic cancers. Finally, we offer multidisciplinary recommendations on the timing of elective hernia repair with obstetrical and gynecologic procedures, with attention to the primary surgical procedure, the type of preexisting hernia, and patient characteristics.
摘要:
产科和妇科疝气患者的管理给照顾他们的提供者带来了挑战。疝气发展的风险包括描述良好的因素,这些因素会损害手术伤口的愈合并增加腹压。在产科医生和妇科医生照顾的不同人群中,孕妇和妇科恶性肿瘤患者发生疝气的风险最高。本文概述了现有文献,重点介绍了由OB/Gyns护理的患者以及常见的术前和术中情况。我们重点介绍了不经常进行疝修补的情况,包括接受非选择性手术的已知或疑似妇科癌症患者的情况。最后,我们提供关于产科和妇科手术选择性疝修补术时机的多学科建议,注意主要的外科手术,先前存在的疝气类型和患者特征。