年复一年的腹腔 Hernia 复发率和风险因素
Priya Bhardwaj1, Maria T Huayllani1, Molly A Olson2
1Department of Plastic and Reconstructive Surgery, The Ohio State University Wexner Medical Center, Columbus.
JAMA surgery
|March 27, 2024
概括
腹腔修复的复发率很高,超过40%在5年内有网状,70%没有网状. 长期跟进对于管理这些具有挑战性的复发至关重要.
科学领域:
- 腹部外科手术 腹部外科手术
- Hernia 修复结果的结果
- 改善外科手术的质量.
背景情况:
- 腹腔修复的复发显著影响患者的生活质量和医疗保健资源.
- 腹腔修复后的复发率很高,从30%到80%不等.
研究的目的:
- 为了确定具有先前 Hernia 修复的患者的同时代腹腔的复发率.
- 为了确定与腹腔的复发相关的风险因素.
主要方法:
- 使用腹部核心健康质量协作登记 (2012-2022) 的回顾性,基于人口的研究.
- 分析了29834名接受网格修复的患者和5599名没有接受网格修复的患者.
- 卡普兰-梅尔分析,以评估年复一年的复发率,并确定相关的风险因素.
主要成果:
- 五年复发率为网状维修的44.9%,无网状维修的73.7%.
- 与更高的复发率相关的因素包括更高的BMI,免疫抑制剂,切口/腹膜,机器人方法,更宽的,生物/可吸收网格和并发症 (SSI,重新手术).
- 与较低的复发率相关的因素包括更大的网状网的宽度,肌释放和关闭;型是最重要的变量.
结论:
- 腹腔的复发率随着时间的推移而增加,在没有网状修复的患者中,复发率显著增加.
- 由于复发的渐进性质,对于接受腹修复的患者来说,长期随访是必不可少的.
- 了解风险因素和优化手术技术对于减少腹腔的复发至关重要.
相关概念视频
01:29Herniated Intervertebral Disc l: Introduction
40
Intervertebral disc herniation refers to the displacement of the nucleus pulposus (the gel-like inner core of the disc) through a tear or weakened area in the annulus fibrosus (the outer fibrous ring). The displaced disc material extends beyond the normal boundaries of the disc space and may compress or irritate nearby spinal nerve roots or, less commonly, the spinal cord.Etiology and Risk FactorsHerniation commonly results from degeneration, in which aging reduces disc hydration and...
40
01:25Hiatal Hernia
86
A hiatal hernia is the abnormal protrusion of the stomach or other abdominal organs through the esophageal hiatus of the diaphragm into the thoracic cavity.Normally, the gastroesophageal junction (GEJ) lies below the diaphragm and is supported by the phrenoesophageal membrane, the diaphragmatic crura, and connective tissues. Weakening of these structures—due to aging, congenital defects like a short esophagus, or increased intra-abdominal pressure from coughing, obesity, pregnancy, or...
86