A systematic review of the surgical treatment of large incisional hernia
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  • 作者：E. B. Deerenberg (1)
    L. Timmermans (1)
    D. P. Hogerzeil (1)
    J. C. Slieker (2)
    P. H. C. Eilers (3)
    J. Jeekel (4)
    J. F. Lange (1)

    1. Department of Surgery     ; Erasmus University Medical Center Rotterdam ; ErasmusMC ; Room Ee-173 ; Postbus 2400 ; 3000 CA ; Rotterdam ; The Netherlands
    2. Department of Surgery     ; Centre Hospitalier Universitaire Vaudois ; Lausanne ; Switzerland
    3. Department of Biostatistics     ; Erasmus University Medical Center Rotterdam ; Rotterdam ; The Netherlands
    4. Department of Neuroscience     ; Erasmus University Medical Center Rotterdam ; Rotterdam ; The Netherlands
  • 关键词：Hernia ; Systematic review ; Surgical repair ; Mesh ; Components separation technique ; Recurrence
  • 刊名：Hernia
  • 出版年：2015
  • 出版时间：February 2015
  • 年：2015
  • 卷：19
  • 期：1
  • 页码：89-101
  • 全文大小：1,755 KB
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  • 刊物类别：Medicine
  • 刊物主题：Medicine & Public Health
    Abdominal Surgery
  • 出版者：Springer Paris
  • ISSN：1248-9204
文摘
Purpose Incisional hernia (IH) is one of the most frequent postoperative complications. Of all patients undergoing IH repair, a vast amount have a hernia which can be defined as a large incisional hernia (LIH). The aim of this study is to identify the preferred technique for LIH repair. Methods A systematic review of the literature was performed and studies describing patients with IH with a diameter of 10聽cm or a surface of 100聽cm2 or more were included. Recurrence hazards per year were calculated for all techniques using a generalized linear model. Results Fifty-five articles were included, containing 3,945 LIH repairs. Mesh reinforced techniques displayed better recurrence rates and hazards than techniques without mesh reinforcement. Of all the mesh techniques, sublay repair, sandwich technique with sublay mesh and aponeuroplasty with intraperitoneal mesh displayed the best results (recurrence rates of Conclusions The use of mesh during LIH repair displayed the best recurrence rates and hazards. If possible mesh in sublay position should be used in cases of LIH repair.

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