中国实用外科杂志

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切口疝复发处理中的陷阱及对策

吴立胜   

  1. 中国科学技术大学附属第一医院(安徽省立医院)疝及肥胖外科,安徽合肥 230001
  • 出版日期:2025-05-01

  • Online:2025-05-01

摘要: 复发性切口疝手术治疗过程中存在诸多陷阱,涉及病人因素、手术技术、材料应用及围手术期管理等多方面。复发的主要原因包括病人基础疾病(如肥胖、糖尿病)、缺损关闭不充分、补片材料选择不当、感染控制失败及术后腹压管理疏漏等。陷阱则体现在过度依赖单一术式、忽视个体化评估、材料与解剖层次匹配不足、术后康复指导缺位等方面。通过整合多学科协作、优化术前评估体系、规范补片选择及强化术后随访,可显著降低复发率。

关键词: 复发, 切口疝, 手术治疗, 对策

Abstract: The surgical management of recurrent incisional hernias remains a significant challenge in the field of abdominal wall surgery, with numerous pitfalls arising from patient-related factors, surgical technique selection, material application, and perioperative management. Studies indicate that the primary causes of recurrence include underlying patient conditions (e.g., obesity, diabetes), inadequate defect closure, inappropriate mesh selection, failure in infection control, and postoperative intra-abdominal pressure management negligence. Key pitfalls include overreliance on a single surgical approach, neglect of individualized assessment, mismatched anatomical layering and material selection, and insufficient postoperative rehabilitation guidance. By integrating multidisciplinary collaboration, optimizing preoperative evaluation protocols, standardizing mesh selection, and strengthening postoperative follow-up, recurrence rates can be significantly reduced.

Key words: recurrence, incisional hernia, surgical treatment, strategies