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在开放的背肌腹修复中,网状固定是必要的吗? 一个元分析
Claudia Theis1, Neophytos Christodoulou2, Victor Andrade Nunes3
1Department of Surgery, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA. claudia_theis@med.unc.edu.
Hernia : the journal of hernias and abdominal wall surgery
|January 16, 2026
概括
在回肌腹修复 (RVHR) 中的网状固定不减少复发,但增加了血液瘤的风险并降低了生活质量. 对于RVHR,建议选择性使用网状固定.
科学领域:
- 一般外科 整体外科
- 手术创新 在外科创新.
背景情况:
- 背肌腹修复 (RVHR) 是一种用于网状布置的流行的技术.
- 对于RVHR中用于最佳结果的网状固定的必要性进行了辩论.
- 固定的潜在好处,如减少复发,被质疑与增加发病率的风险相比.
研究的目的:
- 系统地审查和元分析带有和没有网状固定的RVHR的结果.
- 为了比较固定和非固定组之间的的复发率.
- 评估网状固定对术后疼痛,并发症和生活质量的影响.
主要方法:
- 在PubMed,EMBASE和Cochrane图书馆进行系统的文献搜索,截至2025年7月.
- 包括接受开放RVHR的成年患者,有或没有网状固定.
- 随机效应模型用于对主要结果 (复发,疼痛) 和次要结果 (血液瘤,血清瘤,SSI,重新手术,手术时间,LOS,QoL) 的元分析.
主要成果:
- 包括6项研究 (15,106名患者) 在内.
- 在固定和非固定组之间,的复发没有显著差异 (OR 1.1,95% CI 0.91-1.34).
- 网格固定与明显更差的生活质量得分 (MD -12.71) 和更高的血瘤风险 (OR 5.18) 相关.
结论:
- 在RVHR中,网状固定和非固定之间没有复发,疼痛,手术部位感染或长期结果的差异.
- 网格固定与生活质量降低和血液瘤风险增加有关.
- 这些发现支持选择性的,而不是常规的,在RVHR中对网状固定的方法.
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