Clinical efficacy of posterior component separation with Sublay mesh repair for complex abdominal incisional hernia / 中华消化外科杂志

ABSTRACT

Objective To explore the clinical efficacy of posterior component separation (PCS) with Sublay mesh repair for complex abdominal incisional hernia.Methods The retrospective cross-sectional study was conducted.The clinical data of 30 patients with complex abdominal incisional hernia who were admitted to the Beijing Chao-Yang Hospital of Capital Medical University from July 2016 to March 2017 were collected.Patients intraoperatively received PCS with Sublay mesh repair.Observation indicators(1) intra-and post-operative situationsdefect area of incisional hernia,operation time,volume of intraoperative blood loss,time of postoperative drainage-tube removal,postoperative complications and duration of postoperative hospital stay;(2) follow-up situation.Follow-up using outpatient examination and telephone interview was performed to detect recurrence of hernia and mesh-related complications up to July 2017.Outpatient examination was done once at postoperative month 1,3 and 6 and telephone interview was done at 1 year postoperatively.Measurement data with normal distribution were represented as x±s and measurement data with skewed distribution were described as M (range).Results (1) Intra-and post-operative situations30 patients received successful PCS with Sublay mesh repair for complex abdominal incisional hernia.Defect area of incisional hernia,operation time,volume of intraoperative blood loss and time of postoperative drainage tube removal were respectively (222± 124)cm2,100 minutes (range,40-235 minutes),80 mL (range,50-200 mL) and 5 days (range,2-15 days).Of 7 patients with postoperative complications,3 were complicated with shallow surgical site infection,including 1 with wound healing by vacuum sealing drainage and 2 with delayed healing by debridement and drainage;2 with postoperative seroma were improved by aspiration and local pressurization after 1 months;1 with fat liquefaction of abdominal incision was improved by symptomatic treatment;1 with postoperative active hemorrhage was confirmed with arteriolar hemorrhage of muscular layer and then received hemostasis by ligation.Time of postoperative hospital stay of 30 patients was 15 days (range,10-57 days).(2) Follow-up situation30 patients were followed up for (7± 3) months,without occurrences of hernia recurrence,intestinal fistula and mesh-related complications.Conclusion PCS with Sublay mesh repair for complex abdominal incisional hernia is safe and feasible,with good clinical efficacies.