A Collective Review on Mesh-Based Repair of Umbilical and Epigastric Hernias
A Collective Review on Mesh-Based Repair of Umbilical and Epigastric Hernias
复制标题
脐疝和腹壁疝修补补片的综合评价
DOI：
10.1007/s12262-013-0920-6
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发表时间：
2014
影响因子：
0.4
通讯作者：
S. Nienhuijs
中科院分区：
文献类型：
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作者：
J. Ponten;I. Thomassen;S. Nienhuijs
根据其他疝的无张力原则，脐疝和上腹疝修补术可能应以补片为基础。随机研究的数量正在增加，其中大多数显示使用补片的复发率显著降低。不同的设备是可用的，并适用于几种方法。本综述的目的是评价最近关于不同类型补片用于脐疝和上腹疝修补以及补片修补后复发的文献。进行了多数据库检索，以揭示自2001年以来报告原发性脐疝/上腹疝补片修补术及其在成人患者中结局的相关研究。共纳入20项研究，其中15项仅涉及脐疝，而其余研究也包括上腹疝。每项研究中位调查了124例患者（范围：17-384）。四分之三的纳入研究至少随访2年。6项研究描述了腹腔镜方法的结果，其中1项报告复发率为2.7%;在其余研究中，未发生复发。两项比较研究报告腹腔镜修复术后并发症和术后疼痛的发生率低于开放修复。17项研究报告了开放技术的结果，其中7项研究显示无复发。其他研究报告复发率高达3.1%。报告了各种并发症发生率（0- 33%）。该综述显示，基于补片的脐疝和上腹疝修补术的复发率可接受。对各种器械进行了研究。腹腔镜修复术后并发症发生率高于开腹修复。
In accordance with the tension-free principles for other hernias, umbilical and epigastric hernia repair should probably be mesh-based. The number of randomized studies is increasing, most of them showing significantly less recurrences with the use of a mesh. Different devices are available and are applicable by several approaches. The objective of this review was to evaluate recent literature for the different types of mesh for umbilical and epigastric hernia repair and recurrences after mesh repair. A multi-database search was conducted to reveal relevant studies since 2001 reporting mesh-based repair of primary umbilical/epigastric hernia and their outcomes in adult patients. A total of 20 studies were included, 15 of them solely involved umbilical hernias, whereas the remaining studies included epigastric hernias as well. A median of 124 patients (range, 17–384) was investigated per study. Three quarters of the included studies had a follow-up of at least 2 years. Six studies described the results of laparoscopic approach, of which one reported a recurrence rate of 2.7 %; in the remaining studies, no recurrences occurred. Two comparative studies reported a lower incidence of complications and postoperative pain after laparoscopic repair compared to open repair. Seventeen studies reported results of open techniques, of which seven studies showed no recurrence. Other studies reported recurrence rates up to 3.1 %. A wide range of complication rates were reported (0–33 %). This collective review showed acceptable recurrence rates for mesh-based umbilical and epigastric hernia repair. A wide range of devices was investigated. A tendency toward more complications after laparoscopic repair was found compared to open repair.