Randomized clinical trial of suture repair, polypropylene mesh or autodermal hernioplasty for incisional hernia
Randomized clinical trial of suture repair, polypropylene mesh or autodermal hernioplasty for incisional hernia
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DOI：
10.1046/j.0007-1323.2001.01974.x
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发表时间：
2002-01-01
影响因子：
9.6
通讯作者：
Troidl, H
中科院分区：
文献类型：
--
作者：
Korenkov, M;Sauerland, S;Troidl, H
背景资料：由于传统的缝合修补切口疝是与高复发率，异体和自体假体techniques have been suspended.Methods：在一项随机试验中，160例简单或复杂的疝进行缝合修补，自体皮肤移植或覆盖聚丙烯网片修复。在复杂疝中未进行缝合修复。这份报告涉及到一个计划的中期analysis.Results：在平均随访16个月，有17个疝复发的手术技术之间的分布相似。缝线修补术后的感染并发症（33例患者中的3例）少于植皮或补片修补术后的感染并发症（单纯疝为39例患者中的7例，28例患者中的5例;复杂疝为31例患者中的7例，29例患者中的10例）（P不显著）。聚丙烯补片植入后感染的严重程度促使试验委员会终止研究。住院时间和生活质量无差异。然而，聚丙烯补片修补后疼痛明显更频繁（6周和1年时的合并风险比分别为2.9和1.8）。结论：缝线修补术对小切口疝是安全的。自体和异体疝修补术的复发率均较低，但伤口感染率较高。
Background: Since conventional suture repair for incisional hernia is associated with high recurrence rates, alloplastic and autoplastic prosthetic techniques have been suggested.Methods: In a randomized trial, 160 patients with simple or complex hernias underwent either suture repair, autodermal skin graft or onlay polypropylene mesh repair. Suture repair was not done in complex hernias. This report concerns a planned interim analysis.Results: At mean follow-up of 16 months, there were 17 hernia recurrences that were distributed similarly between the surgical techniques. There were fewer infectious complications after suture repair (three of 33 patients) than after skin graft or mesh repair (seven of 39 and five of 28 for simple hernias; seven of 31 and ten of 29 respectively for complex hernias) (P not significant). The severity of infections after polypropylene mesh implantation prompted the trial committee to discontinue the study. No differences were noted in duration of stay in hospital and quality of life. However, pain was significantly more frequent after polypropylene mesh repair (pooled risk ratio 2.9 and 1.8 at 6 weeks and 1 year respectively).Conclusion: Suture repair was safe for small incisional hernias. Both autoplastic and alloplastic hernia repair yielded comparably low recurrence rates, but led to a high rate of wound infection.