中国组织工程研究

中国组织工程研究 ›› 2011, Vol. 15 ›› Issue (51): 9679-9682.doi: 10.3969/j.issn.1673-8225.2011.51.043

• 生物材料临床实践 clinical practice of biomaterials • 上一篇    下一篇

人工补片修复腹部恶性肿瘤体内应用的远期效应

王刚成1，刘林嶓2，任莹坤1，张薛磊1，韩广森1   

  1. 1郑州大学附属肿瘤医院(河南省肿瘤医院)普外科，河南省郑州市 450008
    2郑州大学第一附属医院整形外科，河南省郑州市    450002
  • 收稿日期:2011-06-16 修回日期:2011-08-11 出版日期:2011-12-17 发布日期:2011-12-17
  • 通讯作者: 韩广森，主任，主任医师，郑州大学附属肿瘤医院(河南省肿瘤医院)普外科，河南省郑州市 450008
  • 作者简介:王刚成★，男，1972年生，河南省西华县人，汉族，2002年郑州大学医学院毕业，硕士，副主任医师，主要从事肿瘤普外专业研究。 gangchengwang2009@yahoo.cn

Long-term clinical effect of artificial mesh application in the repair of abdominal malignant tumor in vivo

Wang Gang-cheng1, Liu Lin-bo2, Ren Ying-kun1, Zhang Xue-lei1, Han Guang-sen1   

  1. 1Department of General Surgery, Affiliated Cancer Hospital of Zhengzhou University (Henan Cancer Hospital), Zhengzhou  450008, Henan Province, China
    2Department of Plastic Surgery, First Affiliated Hospital of Zhengzhou University, Zhengzhou  450002, Henan Province, China
  • Received:2011-06-16 Revised:2011-08-11 Online:2011-12-17 Published:2011-12-17
  • Contact: Han Guang-sen, Chief physician, Department of General Surgery, Affiliated Cancer Hospital of Zhengzhou University (Henan Cancer Hospital), Zhengzhou 450008, Henan Province, China
  • About author:Wang Gang-cheng★, Master, Associate chief physician, Department of General Surgery, Affiliated Cancer Hospital of Zhengzhou University (Henan Cancer Hospital), Zhengzhou 450008, Henan Province, China gangchengwang2009@yahoo.cn

PDF

336

被引次数

4

摘要：

背景：人工补片容易与腹部肠管粘连，甚至出现肠梗阻，为肿瘤复发的再次手术切除带来了巨大困难。
目的：观察腹部恶性肿瘤切除后，应用人工补片修复腹壁缺损所带来的远期临床效应。
方法：回顾性分析因腹部肿瘤切除致腹部缺损患者26例，补片修复腹壁组16例应用聚丙烯类网片、膨体聚四氟乙烯补片和复合补片修复；直接拉拢缝合组10例未用人工补片修复，直接缝合皮下组织及皮肤。比较两组患者的腹壁疝、肠梗阻、再次手术开腹情况。
结果与结论：随访2~10年，补片修复腹壁组16例均未出现腹部疝，6例出现肠梗阻(聚丙烯类网片3例，膨体聚四氟乙烯补片1例，复合补片2例)，7例因肿瘤复发再次手术，补片(聚丙烯类网片4例，膨体聚四氟乙烯补片1例，复合补片2例)与肠粘连严重，入腹困难。直接拉拢缝合组10例均出现腹壁疝，4例因肿瘤复发再次手术，肠粘连轻，入腹顺利。提示人工补片修复腹壁缺损能预防切口疝的发生，但容易导致腹腔粘连，严重影响腹部肿瘤复发再次手术。

关键词: 腹壁缺损, 人工补片, 肿瘤复发, 再次手术, 远期效应

Abstract:

BACKGROUND: Artificial mesh is easily adhesive with the abdominal bowel and even lead to intestinal obstruction. This may bring great difficulty to re-operation of the recurrence tumor.
OBJECTIVE: To evaluate the long-term clinical effect of artificial mesh on repairing abdominal wall defect after abdominal malignant tumor resection.
METHODS: Twenty-six abdominal wall defect patients resulted in abdominal malignant tumor resections were involved for retrospective analysis. Sixteen of them in the artificial mesh group were repaired by polypropylene mesh, expanded polytetrafluoroethylene mesh, and composite mesh. Others repaired by suturing subcutaneous tissue and skin without artificial meshes were taken as suture group. The occurrences of lateral ventral syndrome, bowel obstruction and re-operation of these two groups were analyzed.
RESULTS AND CONCLUSION: During the 2-10 years follow-up, none of the artificial mesh group got lateral ventral syndrome. On the contrary, all cases in the suture group got lateral ventral syndrome. Six cases (3 of polypropylene mesh, 1 of expanded polytetrafluoroethylene mesh, and 2 of composite mesh) of the former group got trouble with bowel obstruction and 7 cases (4 of polypropylene mesh, 1 of expanded polytetrafluoroethylene mesh, and 2 of composite mesh) underwent re-operation because of tumor recurrence. In the re-operations, meshes were greatly adhesive with the bowels, which brought trouble to entering abdomen. Four cases of the latter group underwent re-operation because of tumor recurrence, and the re-operation went on well for the adhesion was not serious. Using artificial mesh to repair the abdominal wall defect after abdominal malignant tumor resection can efficiently prevent the occurrence of lateral ventral syndrome. However, it also can lead to abdominal adhesions, which may bring trouble to re-operation when tumor reoccurs.

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