Repair of giant midline abdominal wall hernias: 'components separation technique' versus prosthetic repair : interim analysis of a randomized controlled trial
| Autor: | Eric J. Hesselink, G.J. van der Wilt, H. van Goor, Camiel Rosman, Robert P. Bleichrodt, T. S. de Vries Reilingh, J. A. Charbon |
|---|---|
| Rok vydání: | 2007 |
| Předmět: |
Adult
Male Tissue engineering and reconstructive surgery [UMCN 4.3] medicine.medical_specialty Adolescent medicine.medical_treatment Prosthesis Article Surgical Flaps law.invention Abdominal wall Postoperative Complications Randomized controlled trial law medicine Humans Hernia Polytetrafluoroethylene Aged Aged 80 and over business.industry Effective Hospital Care [EBP 2] Middle Aged Plastic Surgery Procedures Surgical Mesh medicine.disease Interim analysis Surgery Hernia Abdominal Pathogenesis and modulation of inflammation [N4i 1] Surgical mesh medicine.anatomical_structure Treatment Outcome Cardiothoracic surgery Evaluation of complex medical interventions [NCEBP 2] Female business Abdominal surgery |
| Zdroj: | World Journal of Surgery, 31, 4, pp. 756-63 World Journal of Surgery World Journal of Surgery, 31, 756-63 |
| ISSN: | 0364-2313 |
| Popis: | Contains fulltext : 51559.pdf (Publisher’s version ) (Closed access) BACKGROUND: Reconstruction of giant midline abdominal wall hernias is difficult, and no data are available to decide which technique should be used. It was the aim of this study to compare the "components separation technique" (CST) versus prosthetic repair with e-PTFE patch (PR). METHOD: Patients with giant midline abdominal wall hernias were randomized for CST or PR. Patients underwent operation following standard procedures. Postoperative morbidity was scored on a standard form, and patients were followed for 36 months after operation for recurrent hernia. RESULTS: Between November 1999 and June 2001, 39 patients were randomized for the study, 19 for CST and 18 for PR. Two patients were excluded perioperatively because of gross contamination of the operative field. No differences were found between the groups at baseline with respect to demographic details, co-morbidity, and size of the defect. There was no in-hospital mortality. Wound complications were found in 10 of 19 patients after CST and 13 of 18 patients after PR. Seroma was found more frequently after PR. In 7 of 18 patients after PR, the prosthesis had to be removed as a consequence of early or late infection. Reherniation occurred in 10 patients after CST and in 4 patients after PR. CONCLUSIONS: Repair of abdominal wall hernias with the component separation technique compares favorably with prosthetic repair. Although the reherniation rate after CST is relatively high, the consequences of wound healing disturbances in the presence of e-PTFE patch are far-reaching, often resulting in loss of the prosthesis. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full text from SpringerLink