与肋间相关的肋间边缘破裂的外科治疗:技术的发展
Pradeep Wijerathne1, Jagan N Rao, Mathieu M E Wijffels
1From the Sheffield Teaching Hospitals NHS Foundation Trust (P.W., J.N.R., S.T., J.G.E.), Sheffield, England; Erasmus Medical Centre (M.M.E.W.), Rotterdam, The Netherlands; and University Hospital of Southampton NHS Foundation Trust (A.T.).
The journal of trauma and acute care surgery
|December 29, 2024
概括
肋间边缘破裂与肋间的手术修复具有挑战性. 一种进化的双层网格修复技术 (Mk 3) 显著减少了重复手术,为这些罕见的伤害提供了持久的解决方案.
科学领域:
- 胸部外科手术 胸部外科手术
- 手术方面的创新.
- Hernia 修复 Hernia 修复 的方法
背景情况:
- 肋骨边缘破裂 (CMR) 和肋间 (IH) 是罕见的,具有症状的损伤,具有显著的手术挑战.
- 报告的CMR-IH/TDIH手术失败率可能高达60%,最佳管理技术尚不清楚.
研究的目的:
- 标志着肋间边缘破裂与肋间间损伤的特征.
- 描述这些复杂病例的外科管理技术的演变.
主要方法:
- 使用谢菲尔德分类来预期识别CMR-IH或跨膜间 (TDIH) 的患者.
- 手术技术从简单的修复演变为代的双层网格修复 (DLMR),包括使用生物网格和支柱板的Mk 3.
- 相关程序包括手术稳定肋骨骨折和肋边边板固定.
主要成果:
- 25名CMR-IH患者和11名TDIH患者接受了手术,其中5名患者进行了6次重复手术.
- 与DLMR相比,和胸外网格修复的重新操作率更高.
- Mk 3 DLMR 技术 (n=6) 没有重新操作,显示出更好的结果.
- 板稳定表现出不同的成功,取决于肋骨软骨水平.
结论:
- 修复CMR-IH/TDIH仍然是一个复杂的外科手术项目.
- 基于经验的外科手术技术的发展已经导致了耐用和可重复的 Mk 3 双层网格修复.
- Mk 3 DLMR在管理这些具有挑战性的伤害方面取得了重大进展.
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