合并肝硬化的脐疝修补术的远期疗效
Longterm outcomes of umbilical hernia repair in cirrhotics
目的 肝硬化脐疝的手术指征仍存在争议,总结这一特殊群体的病例资料,为临床工作提供参考.方法 回顾性分析自2009年1月至2015年12月65例脐疝合并肝硬化实施修补术患者的资料,并进行随访.结果 65例患者中急诊手术32例,发生切口感染2例,肝性脑病2例.择期手术34例,术后发生切口血肿1例.13例补片修补的患者无切口并发症.全部病例均痊愈出院,30 d内无死亡病例.随访时间5~ 86个月,中位随访时间31个月,失访3例,复发3例,复发率4.8%.总病死率51.6%.急诊手术患者1年期病死率32.3%,择期患者1年期病死率16.1%.结论 择期手术相比急诊手术,并发症少,远期病死率低.聚丙烯补片修补对于肝硬化脐疝患者是安全的.患者远期生存决定于肝硬化的进展程度.
更多Objective To evaluate umbilical hernia repair in cirrhotic patients.Methods Clinical data of 65 cirrhotics undergoing umbilical hernia repair from Jan 2009 to Dec 2015 were retrospectively analyzed.Results 32 cases underwent emergency surgery,2 cases were complicated with incision infection,2 cases suffered from hepatic encephalopathy.34 cases underwent elective surgery,1 case had incision hematoma but there was no incision complication in the 13 patients with mesh repair.All cases were cured,and no patient died in 30 days after the operation.The median follow-up time was 31 months and the mortality rate was 51.6%,and 3 cases were lost to follow up.Recurrence developed in 3 cases,the recurrence rate was 4.8%.One-year mortality rate was 32.3% in emergency patients and 16.1% in elective patients.Conclusions The elective surgery has less complication and low mortality rate compared with emergency operation.Polypropylene mesh repair for umbilical hernia complicated with cirrhosis is safe.Long term survival is dependent on the progress of liver cirrhosis.
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