Open Incisional Hernia Repair at an Academic Tertiary Care Medical Center

被引:6
作者
Mohebali, Khashayar [2 ]
Young, David M. [2 ]
Hansen, Scott L. [2 ]
Shawo, Alexandra [1 ]
Freise, Christopher E. [3 ]
Chang, David S.
Maa, John [1 ]
Harris, Hobart W. [1 ]
机构
[1] Univ Calif San Francisco, Dept Surg, Div Gen Surg, San Francisco, CA 94143 USA
[2] Univ Calif San Francisco, Dept Surg, Div Plast & Reconstruct Surg, San Francisco, CA 94143 USA
[3] Univ Calif San Francisco, Dept Surg, Div Transplant Surg, San Francisco, CA 94143 USA
关键词
ACELLULAR DERMAL MATRIX; ABDOMINAL-WALL DEFECTS; MESH REPAIR; POLYPROPYLENE MESH; VENTRAL HERNIAS; SUTURE REPAIR; CLOSURE; INTRAPERITONEAL; MANAGEMENT; TRIAL;
D O I
10.1001/archsurg.2009.161
中图分类号
R61 [外科手术学];
学科分类号
摘要
Objective: To describe the postoperative complication rates of a large consecutive series of patients who underwent open incisional ventral hernia repair. Design: Retrospective medical record review of an accumulated database. Setting: University tertiary care medical center. Patients: All patients who underwent open incisional ventral hernia repair from March 1., 2003, through February 28, 2008. Intervention: Open incisional ventral hernia repair. Main Outcome Measures: Postoperative complications, including hernia recurrences. Results: A total of 507 cases (465 patients; female to male ratio, 1.1:1) met our criteria; median follow-up was 40 months. In 23.5% of the cases, repair had been attempted previously, and 16.4% had previously undergone organ transplant. The postoperative complication rate was 38.1%. Hernias recurred in 18.9% of cases. Perioperative mortality was 1.0%. Patients undergoing transplant were more likely than those not undergoing transplant to have a hernia recurrence (16.3% vs 32.5%; P<.001) and were equally likely to have a postoperative complication (36.9% vs 44.6%; P=.19). Patients who underwent repair of a recurrent incisional hernia were as likely to have a hernia recurrence as those who underwent initial repair (21.0% vs 18.3%; P=.52) but more likely to have an overall complication (47.9% vs 35.1%; P=.01). Conclusions: In this series of incisional hernia repairs at a tertiary care center, the overall recurrence rate of 18.9% is comparable to that of other published series. Ours is the largest published series of recurrent hernias that shows a recurrence rate comparable to that for initial repairs. This outcome may be the result of greater use of more complex repair techniques.
引用
收藏
页码:848 / 852
页数:5
相关论文
共 25 条
[1]   The single-staged approach to the surgical management of abdominal wall hernias in contaminated fields [J].
Alaedeen D.I. ;
Lipman J. ;
Medalie D. ;
Rosen M.J. .
Hernia, 2007, 11 (1) :41-45
[2]  
Balén EM, 1998, BRIT J SURG, V85, P1415
[3]   BURST ABDOMEN AND INCISIONAL HERNIA - A PROSPECTIVE-STUDY OF 1129 MAJOR LAPAROTOMIES [J].
BUCKNALL, TE ;
COX, PJ ;
ELLIS, H .
BMJ-BRITISH MEDICAL JOURNAL, 1982, 284 (6320) :931-933
[4]  
Burger JWA, 2004, ANN SURG, V240, P578
[5]   Use of human acellular dermal matrix for hernia repair: Friend or foe? [J].
Candage, Raymond ;
Jones, Keith ;
Luchette, Fred A. ;
Sinacore, James M. ;
Vandevender, Darl ;
Reed, R. Lawrence, II .
SURGERY, 2008, 144 (04) :703-711
[6]  
den Hartog D, 2008, COCHRANE DB SYST REV, DOI 10.1002/14651858.CD006438.pub2
[7]  
GEORGE CD, 1986, ANN ROY COLL SURG, V68, P185
[8]   Expanded polytetrafluoroethylene patches used in the intraperitoneal or extraperitoneal position for repair of incisional hernias of the anterolateral abdominal wall [J].
Gillion, JF ;
Begin, GF ;
Marecos, C ;
Fourtanier, G .
AMERICAN JOURNAL OF SURGERY, 1997, 174 (01) :16-19
[9]   THE DASILVA METHOD OF INCISIONAL HERNIA REPAIR [J].
HOPE, PG ;
CARTER, SS ;
KILBY, JO .
BRITISH JOURNAL OF SURGERY, 1985, 72 (07) :569-570
[10]   Acellular dermal matrix in the management of high-risk abdominal wall defects [J].
Kim, Hyong ;
Bruen, Kevin ;
Vargo, Daniel .
AMERICAN JOURNAL OF SURGERY, 2006, 192 (06) :705-708