Karmaşık ve büyük kesi fıtıklarının onarımı: Ön bileşen ayırma tekniği ile modifiye rives-stoppa tekniğinin karşılaştırılması

Yıl 2024, Cilt: 4 Sayı: 3, 92 - 100, 20.12.2024

Suat Benek , İlhan Bali

https://doi.org/10.58961/hmj.1552050

Öz

Arka Plan: İnsizyonel herniler, abdominal cerrahilerden sonra sık görülen komplikasyonlardan biridir. Bu makalede, anterior komponent ayırma tekniği (ACST) ile modifiye rives-stoppa tekniğini (MRST) karşılaştırdık.
Materyaller ve yöntemler: Ocak 2017 ile Aralık 2022 arasında büyük insizyonel herni nedeniyle ameliyat edilen 78 hastanın kayıtları incelendi. En az 1 yıl takip edilen, 10 cm'den büyük abdominal defekti olan ve alan kaybı ≥%20 olan hastalar çalışmaya dahil edildi. Bağışıklık sistemini baskılayan hastalar, ciddi kardiyak, solunum ve karaciğer yetmezliği olan hastalar çalışmaya dahil edilmedi. Hastalar iki bölüme ayrıldı: mesh destekli ACST (grup 1) ve MRST (grup 2). Gruplar, tekrarlama, komplikasyonlar ve diğer klinik özellikler açısından karşılaştırıldı.
Sonuçlar: Grup 1'de 33 hasta ve grup 2'de 29 hasta çalışmaya dahil edildi. İki grup arasında ameliyat süresi, ameliyat sonrası hastanede kalış süresi, dren sayısı, dren çıkarma süresi ve normal hayata dönüş açısından fark görüldü. Grup 2'de ameliyat süresi, ameliyat sonrası hastanede kalış süresi ve normal hayata dönüş daha kısaydı, kullanılan dren sayısı daha azdı ve drenler daha erken çıkarıldı. İki grup arasında ameliyat sonrası ağrı skoru (VAS) açısından fark görüldü. Grup 2'de ağrı skoru 1. ve 3. günlerde daha düşüktü.
Sonuç: Sonuç olarak, iki grup arasında tekrarlama ve ameliyat sonrası morbidite açısından fark olmasa da, maliyet-etkin sonuçlar açısından ameliyat süresi, ameliyat sonrası ağrı, hastanede kalış süresi ve normal hayata dönüş açısından fark bulundu.
Anahtar kelimeler: Büyük kesi fıtığı, tekrarlayan fıtık, rives-stoppa, bileşen ayırma tekniği

Anahtar Kelimeler

Dev insizyonel herni, nüks herni, river stoppa, birleşenlerine ayırma tekniği

Etik Beyan

etik kurul kararı alınmıştır

Destekleyen Kurum

Destekleyen kurum yok

Repair of complex and large incisional hernias: Comparison of anterior component separation technique and modified rives-stoppa technique

Öz

Repair of complex and large incisional hernias: Comparison of anterior component separation technique and modified rives-stoppa technique
Abstract
Background: Incisional hernias are one of the common complications after abdominal surgeries. In this article, we compared the anterior component separation technique (ACST) and the modified rives-stoppa technique (MRST).
Materials and methods: The records of 78 patients who underwent surgery for large incisional hernia between January 2017 and December 2022 were reviewed. Patients who were followed for at least 1 year, had an abdominal defect larger than 10 cm and area loss ≥20% were included in the study. Immunosuppressive patients, patients with severe cardiac, respiratory and hepatic insufficiency were not included in the study. The patients were divided into two parts: mesh-supported ACST (group 1) and MRST (group 2). The groups were compared in terms of recurrence, complications, and other clinical features.
Results: 33 patients in group 1 and 29 patients in group 2 were included in the study. The difference was seen between the two groups in terms of surgery time, postoperative hospital stay, number of drains, drain removal time, and return to normal life. In Group 2, the duration of surgery, postoperative hospital stay and return to normal life were shorter, the number of drains used was less, and the drains were removed earlier. The difference was seen between the two groups in terms of postoperative pain score (VAS). In Group 2, the pain score was lower on the 1st and 3rd days.
Conclusion: In conclusion, although there was no difference between the two groups in terms of recurrence and postoperative morbidities but a difference was found in terms of duration of surgery, postoperative pain, length of hospital stay and return to normal life in terms of cost-effective results.
Keywords: Large incisional hernia, recurrent hernia, rives-stoppa, component separation technique

Anahtar Kelimeler

Large incisional hernia, recurrent hernia, rives-stoppa, component separation technique

Kaynakça

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