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首页> 外文期刊>Surgical Endoscopy >Retro-rectus placement of bio-absorbable mesh improves patient outcomes
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Retro-rectus placement of bio-absorbable mesh improves patient outcomes

机译：生物可吸收网格的复古 - 直肠放置改善了患者结果

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BackgroundThere is little consensus on the ideal anatomical placement of bio-absorbable mesh. We hypothesized that retro-rectus placement of bio-absorbable mesh would significantly reduce recurrence rates when compared to intraperitoneal mesh placement.MethodsA retrospective review was conducted of patients who underwent open complex ventral hernia repair using bio-absorbable mesh (Bio-A, Gore, Flagstaff, AZ). Patient demographics and Centers for Disease Control wound type were collected.ResultsA total of 81 patients were included. Seventy-four (91.4%) of these hernia repairs had mesh in the retro-rectus position, while 7 (8.6%) had intraperitoneal mesh placement. Patient demographics, including preoperative comorbidities, did not differ between groups. The retro-rectus group trended to have larger hernia defects (156.2cm(2)) compared to the intraperitoneal group (63.9cm(2)) (p=0.058). Overall complications (e.g., dehiscence, wound drainage, cellulitis, sepsis) were also similar in both groups of patients. Recurrence rates in the retro-rectus and intraperitoneal group were 8.1% and 42.9%, respectively (p=0.005). When evaluating only patients with CDC class 1 wounds, the recurrence rate in the retro-rectus group was 8.2% and the intraperitoneal group was 50% (p=0.02). Overall, the average patient follow-up was 22months and did not differ between groups. Both the retro-rectus and intraperitoneal groups indicated a significant (p 7days) antibiotics were used and no mesh implants were removed during the study.ConclusionPatients who underwent open complex ventral hernia repairs with bio-absorbable mesh in the retro-rectus position experienced lower overall complication rates than those with intraperitoneal mesh placement. Despite a larger hernia defect in the retro-rectus group, recurrence rates were significantly reduced with retro-rectus placement of mesh compared to intraperitoneal placement. In addition, recurrence rates using bio-absorbable mesh in clean wounds are comparable to previously published recurrence rates with permanent mesh.
机译：Backgroundshere对生物可吸收滤网的理想解剖展示来说几乎没有达成共识。我们假设与腹膜内网格置入相比，生物可吸收网格的重新激素放置生物可吸收网格的放置将显着降低复发率。通过生物可吸收网格（Bio-A，血型，血管，血型）进行接受开放的复杂腹膜修复的患者进行了患者的复发率。弗拉格斯塔夫，AZ）。收集了患者人口统计学和疾病控制伤口型中心。包括81名患者的总共有81名患者。这些疝修理的七十四（91.4％）在复古直肠位置网呈网，而7（8.6％）有腹膜内的啮合。患者人口统计学，包括术前共聚物，群体之间没有差异。与腹膜内组（63.9厘米（2））相比，复古肌侧越大培训患者患者较大（156.2厘米（2））（P = 0.058）。两组患者中也相似，整体并发症（例如，裂开，伤口引流，蜂窝织炎，败血症）也相似。复古 - 直肠和腹膜内组的复发率分别为8.1％和42.9％（p = 0.005）。当仅评估CDC类1伤口的患者时，复古直肠组中的复发率为8.2％，腹膜内基团为50％（P = 0.02）。总体而言，平均患者随访是22个月，群体之间没有差异。复古 - 直肠和腹膜内群体都表明了显着的（p 7天）抗生素，在研究期间没有去除网状植入物。在复古 - 直肠位置的生物可吸收网格中接受开放复合腹膜修复的结论韧性，经历了较低的整体并发症比具有腹膜内网格的速率。尽管疝气缺陷在复古 - 直肠组中，与腹膜内放置相比，近期肠道术后，复发率明显减少。此外，使用在清洁伤口中使用生物可吸收网格的复发速率与先前公开的具有永久性网格的复发率相当。

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