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腹腔内网是否会增加肠道阻塞的风险? 一个全国性的法国分析

Théophile Delorme¹, Jonathan Cottenet², Fawaz Abo-Alhassan¹

¹Department of Digestive Surgery, Dijon University Hospital, 14, Rue Paul Gaffarel, Dijon, 21079, France.

Hernia : the journal of hernias and abdominal wall surgery

|September 28, 2023

概括

使用腹腔内网 (IPOM) 进行 laparoscopic 切口修复 (IHR) 增加了五年内肠道阻塞的风险. 这一发现对于考虑IHR的患者来说至关重要,以了解潜在的长期并发症.

科学领域:

腹部外科手术腹部外科手术
胃肠病学胃肠病学
手术创新在外科创新.

背景情况:

切口明显损害生活质量.
网状修复是切口修复 (IHR) 的标准,以防止复发.
对于IHR的最佳网格位置仍在争论中.

研究的目的:

调查腹腔镜切口修复与腹膜内膜网 (IPOM) 和随后肠道阻塞的风险之间的关联.
为了比较IPOM患者的肠道阻塞率与具有类似外科病史但没有IHR患者的肠道阻塞率.

主要方法:

全国范围,使用法国医院数据库 (PMSI) 进行基于人口的研究.
创建了两个队列:接受腹腔镜IPOM (2013-2014) 的患者和没有IHR的匹配对照组.
随访至2019年,以确定肠道阻塞发作.

主要成果:

总共有815名IPOM组患者与1630名对照组进行了匹配.
在IPOM组的5年肠道阻塞率为7.36%,对照组为4.42% (p < 0.01).
在调整年龄和肥胖后,腹腔镜IPOM显著增加了肠道阻塞的风险 (HR=1.712,p=0.0025).

结论:

用腹腔内网进行 laparoscopic 切口的修复与更高的肠道阻塞风险有关.
接受IPOM的患者面临的风险比那些有类似的手术史但没有修复的患者更高.
这突显了IPOM对切口的潜在长期并发症.

关键词:

粘合物粘合物粘合物肠道阻塞肠道阻塞切口椎间板裂纹的切口.内内网的网状组织.网格的位置网格的位置.亚层的网状网状网格.

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