中国实用外科杂志

中国实用外科杂志

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基于大网膜瓣三明治桥接技术修复巨大腹壁缺损23例疗效分析

宋致成a，杨董超a，董文培a，冯少清b，胡    敏a，杨建军a，章一新b，顾    岩a   

  1. 上海交通大学医学院附属第九人民医院    a.普外科  b.整复外科，上海 200011
  • 出版日期:2021-04-01 发布日期:2021-04-20

  • Online:2021-04-01 Published:2021-04-20

摘要： 目的    探讨基于大网膜瓣的生物补片-带蒂大网膜瓣-合成补片三明治（BOSS）桥接技术修复巨大腹壁缺损的手术方案并分析疗效。方法  回顾性分析2016年1月至2020年12月上海交通大学医学院附属第九人民医院收治的23例巨大腹壁缺损病人临床资料，分析BOSS桥接技术修复巨大腹壁缺损的临床效果及可行性。结果    所有病人均顺利完成手术。腹壁缺损面积为（422.2±334.1）cm2，术中出血量为（450.0±420.0）mL，手术时间为（205.8±80.9）min。术后随访（24.4±17.4）个月，疝复发或补片膨出发生率为4.3%，切口并发症发生率为13.0%。结论    采用BOSS桥接技术修复巨大腹壁缺损可显著改善腹壁修复重建效果。

关键词: 巨大腹壁缺损, 桥接修复术, 大网膜瓣

Abstract: Biological-omentum-synthetic sandwich repair technique for huge abdominal wall defect repair and reconstruction：A therapeutic effect analysis of 23 patients        SONG Zhi-cheng*，YANG Dong-chao，DONG Wen-pei，et al. *Department of General Surgery，Shanghai Ninth People’s Hospital，Shanghai Jiao Tong University School of Medicine; Hernia and Abdominal Wall Disease Center，Shanghai Jiao Tong University，Shanghai 200011，China
Corresponding author：GU Yan，E-mail：yangu@sjtu.edu.cn
Abstract    Objective    To study the effect of repairing large abdominal wall defects with the "sandwich" bridging technique based on the omental flap. Methods    The clinical data of 23 patients with large abdominal wall defects admitted between January 2016 and December 2020 in the Ninth People's Hospital Affiliate to Shanghai Jiao Tong University School of Medicine were analyzed retrospectively. The clinical effect of the "sandwich" (biological-omentum-synthetic sandwich，BOSS) bridging technology to repair large abdominal wall defects were analyzed. Results    BOSS bridging technique was successfully performed in all patients. The average area of abdominal wall defect was （422.2±334.1）cm2. The average of intraoperative bleed was (450.0±420.0) mL. The average of operation time was (205.8±80.9) mins. Follow-up time was (24.4±17.4) months. The rate of postoperative hernia recurrence/mesh bulging was 4.3% and incision complication rate was 13%. Conclusion    BOSS bridging technology could significantly improve the repair and reconstruction effect for huge abdominal wall defects patients.

Key words: large abdominal wall defect, bridging repair technique, omental flap