Abstract：
CONCLUSIONS: After pregnancy, some women experience severe rectus diastasis (RD), with body control dysfunction, midline hernia, or other quality-of-life impairment. The purpose of this study was to describe the authors\' experience using hydrodissection and epidural anesthesia for lateral plication modification of abdominoplasty to restore abdominal wall firmness. A total of 46 consecutive patients with RD after pregnancy were enrolled. The mean intraoperative inter-rectus distance was 4.6 cm. RD is not always the only structure that has been elongated. Firmness of the abdominal wall also depends on lateral fascia structures. This study reports the total plicated distance addressing the lateral laxity in the abdominal wall. In this series, total plication was 7.8 cm, and 16 patients had a midline hernia. No hernia recurrences occurred, and the rectus bellies were less than 5 mm apart from each other in all participants, verified with ultrasound after 2 years of follow-up. Patient perspective of care and surgical outcome were recorded. Health-related quality-of-life domains were significantly improved postoperatively. Lumbar back pain visual analogue scale score was 4.5 ± 2.3 preoperatively and 0.5 ± 0.9 postoperatively. The ability to perform sit-ups increased from zero to 11, suggesting better motor control. The total complication rate was 10.9%. Hydrodissection and epidural anesthesia for lateral plication modification offers a reliable and effective treatment method for RD repair with and without a small midline hernia with a low complication rate.
METHODS: Therapeutic, IV.
METHODS: Therapeutic, IV.
摘要：
结论：怀孕后，一些女性经历严重的直肌舒张（RD），身体控制功能障碍，中线疝,或其他生活质量损害。这项研究的目的是描述作者使用液压解剖和硬膜外麻醉进行腹部成形术的外侧折叠改良以恢复腹壁硬度的经验。共纳入46例妊娠后RD患者。术中平均直肌间距离为4.6cm。RD并不总是唯一被拉长的结构。腹壁的坚固性也取决于外侧筋膜结构。这项研究报告了解决腹壁侧向松弛的总复杂距离。在这个系列中,总折叠为7.8厘米，16例患者有中线疝。无疝气复发,所有参与者的腹肌之间的距离都小于5毫米，随访2年后用超声检查证实。记录患者对护理的看法和手术结果。术后健康相关生活质量领域显著改善。腰背痛视觉模拟评分术前4.5±2.3,术后0.5±0.9。仰卧起坐的能力从0增加到11，表明更好的运动控制。总并发症发生率为10.9%。用于外侧折叠术的液压解剖和硬膜外麻醉为有或没有小中线疝的RD修复提供了一种可靠有效的治疗方法，并发症发生率低。
方法：治疗，IV.
方法：治疗，IV.
