Araştırma Makalesi
İnsizyonel herninin açık yöntemle tamirinde cilt altı dren kullanımının iyileşme sürecine ve nüks gelişimine etkisi
Öz
Amaç: İnsizyonel fıtıklar, karın cerrahisi işlemlerini takiben sık görülen bir komplikasyondur. Bu retrospektif çalışma, mesh kullanılarak insizyonel fıtık onarımı sonrası iyileşme sürecinde perioperatif drenlerin rolünü değerlendirmeyi amaçlamaktadır.
Gereç ve Yöntem: Elektif insizyonel herni onarımı uygulanan toplam 117 hasta analiz edildi. Hastalar perioperatif olarak subkutan dren koyulup koyulmadığına göre iki gruba ayrıldı. Çeşitli klinik sonuçlar değerlendirildi.
Bulgular: Drenler %64,1 hastada kullanılmış, seroma ve yara enfeksiyonu oranları her biri için %6 olarak saptanmış ve nüks oranı %11,9 olarak belirlenmiştir. Defekt boyutu dren kullanımını anlamlı şekilde artırırken, BMI hastanede kalış süresini birim başına %7 oranında uzatmıştır. Nüks, seroma ve yara enfeksiyonları diğer faktörlerden anlamlı şekilde etkilenmemiştir.
Sonuç: Çalışmanın sonuçları, insizyonel fıtık onarımında drenlerin rutin kullanımının gerekli olmayabileceğini ve faydalarının belirsiz kaldığını öne sürmektedir.
Anahtar Kelimeler
Etik Beyan
This study was approved by the Clinical Studies Ethics Board of Balıkesir University (date: 20.12.2023, No. 2023/191). This study conformed to the principles of Helsinki Declaration.
Destekleyen Kurum
The authors received no financial support for the research.
Teşekkür
None.
Kaynakça
- Gurusamy KS, Samraj K. Wound drains after incisional hernia repair. Cochrane Database Syst Rev. 2007;(1).
- López-Cano M. Editorial: Incisional Hernia Prevention. J Abdom wall Surg JAWS. 2023;2:11495. doi:10.3389/jaws.2023.11495
- Kössler-Ebs JB, Grummich K, Jensen K, et al. Incisional hernia rates after laparoscopic or open abdominal surgery—a systematic review and meta-analysis. World J Surg. 2016;40:2319-2330.
- Deerenberg EB, Henriksen NA, Antoniou GA, et al. Updated guideline for closure of abdominal wall incisions from the European and American Hernia Societies. Br J Surg. 2022;109(12):1239-1250.
- Kroese LF, Gillion J-F, Jeekel J, Kleinrensink G-J, Lange JF. Primary and incisional ventral hernias are different in terms of patient characteristics and postoperative complications-A prospective cohort study of 4,565 patients. Int J Surg. 2018;51:114-119.
- Bosanquet DC, Ansell J, Abdelrahman T, et al. Systematic review and meta-regression of factors affecting midline incisional hernia rates: analysis of 14 618 patients. PLoS One. 2015;10(9):e0138745.
- Cassar K, Munro A. Surgical treatment of incisional hernia. Br J Surg. 2002;89(5):534-545.
- Sauerland S, Walgenbach M, Habermalz B, Seiler CM, Miserez M. Laparoscopic versus open surgical techniques for ventral or incisional hernia repair. Cochrane database Syst Rev. 2011;(3).
- Olavarria OA, Bernardi K, Dhanani NH, et al. Synthetic versus biologic mesh for complex open ventral hernia repair: a pilot randomized controlled trial. Surg Infect (Larchmt). 2021;22(5):496-503.
- Eker HH, Hansson BME, Buunen M, et al. Laparoscopic vs open incisional hernia repair: a randomized clinical trial. JAMA Surg. 2013;148(3):259-263.
- Kokotovic D, Bisgaard T, Helgstrand F. Long-term recurrence and complications associated with elective incisional hernia repair. Jama. 2016;316(15):1575-1582.
- Pereira JA, Bravo-Salva A, Montcusí B, Pérez-Farre S, Fresno de Prado L, López-Cano M. Incisional hernia recurrence after open elective repair: expertise in abdominal wall surgery matters. BMC Surg. 2019;19:1-6.
- Romain B, Renard Y, Binquet C, et al. Recurrence after elective incisional hernia repair is more frequent than you think: an international prospective cohort from the French Society of Surgery. Surgery. 2020;168(1):125-134.
- Sahm M, Pross M, Hukauf M, Adolf D, Köckerling F, Mantke R. Drain versus no drain in elective open incisional hernia operations: a registry-based analysis with 39,523 patients. Hernia. Published online 2023:1-15.
- Luo Y, Mohammed Jinnaah S, Masood D, Hodgson R. Drain tube use in incisional hernia repair: a national survey. Hernia. 2021;25:427-433.
- Shankar H, Sureshkumar S, Gurushankari B, Sreenath GS, Kate V. Factors predicting prolonged hospitalization after abdominal wall hernia repair-a prospective observational study. Turkish J Surg. 2021;37(2):96.
- Willemin M, Schaffer C, Kefleyesus A, et al. Drain versus no drain in open mesh repair for incisional hernia, results of a prospective randomized controlled trial. World J Surg. 2023;47(2):461-468.
- Miller BT, Tamer R, Petro CC, et al. Retromuscular drain versus no drain in robotic retromuscular ventral hernia repair: a propensity score-matched analysis of the abdominal core health quality collaborative. Hernia. 2023;27(2):409-413.
- Mohamedahmed AYY, Zaman S, Ghassemi N, et al. Should routine surgical wound drainage after ventral hernia repair be avoided? A systematic review and meta-analysis. Hernia. 2023;27(4):781-793.
- Westphalen AP, Araújo ACF, Zacharias P, Rodrigues ES, Fracaro GB, Lopes Filho G de J. Repair of large incisional hernias. To drain or not to drain. Randomized clinical trial. Acta Cir Bras. 2015;30:844-851.
- Louis V, Diab S, Villemin A, et al. Do surgical drains reduce surgical site occurrence and infection after incisional hernia repair with sublay mesh? A non-randomised pilot study. Hernia. 2023;27(4):873-881.
- Bueno-Lledó J, Bonafe-Diana S, Carbonell-Tatay F, Torregrosa-Gallud A, Pous-Serrano S. Component separation and large incisional hernia: predictive factors of recurrence. Hernia. 2021;25(6):1593-1600.
- Van Silfhout L, Leenders LAM, Heisterkamp J, Ibelings MS, Tilburg VHG. Recurrent incisional hernia repair: surgical outcomes in correlation with body-mass index. Hernia. 2021;25:77-83.
- Gignoux B, Bayon Y, Martin D, et al. Incidence and risk factors for incisional hernia and recurrence: retrospective analysis of the French national database. Color Dis. 2021;23(6):1515-1523.
- Moreno-Egea A, Carrillo-Alcaraz A, Aguayo-Albasini JL. Is the outcome of laparoscopic incisional hernia repair affected by defect size? A prospective study. Am J Surg. 2012;203(1):87-94.
The effect of subcutaneous drain use on the healing process and development of recurrences in open repair of incisional hernias
Öz
Aim: Incisional hernias are a common complication following abdominal surgical procedures. This retrospective study aimed to evaluate the role of perioperative drains in the healing process following incisional hernia repair using mesh.
Materials and Methods: A total of 117 patients who underwent elective hernia repair surgery were analyzed. Patients were divided into two groups based on whether a subcutaneous drain was inserted perioperatively. Various clinical outcomes were assessed.
Results: Drains were used in 64.1%, with seroma and surgical site infections observed in 6% each and a recurrence rate of 11.9%. Defect size significantly increased drain use, while BMI prolonged hospital stay by 7% per unit. Recurrence, seroma, and surgical site infections were not significantly affected by other factors.
Conclusion: The results of the study suggest that routine use of drains in incisional hernia repair may not be necessary and that their benefits remain uncertain.
Anahtar Kelimeler
Etik Beyan
This study was approved by the Clinical Studies Ethics Board of Balıkesir University (date: 20.12.2023, No. 2023/191). This study conformed to the principles of Helsinki Declaration
Destekleyen Kurum
The authors received no financial support for the research.
Teşekkür
None.
Kaynakça
- Gurusamy KS, Samraj K. Wound drains after incisional hernia repair. Cochrane Database Syst Rev. 2007;(1).
- López-Cano M. Editorial: Incisional Hernia Prevention. J Abdom wall Surg JAWS. 2023;2:11495. doi:10.3389/jaws.2023.11495
- Kössler-Ebs JB, Grummich K, Jensen K, et al. Incisional hernia rates after laparoscopic or open abdominal surgery—a systematic review and meta-analysis. World J Surg. 2016;40:2319-2330.
- Deerenberg EB, Henriksen NA, Antoniou GA, et al. Updated guideline for closure of abdominal wall incisions from the European and American Hernia Societies. Br J Surg. 2022;109(12):1239-1250.
- Kroese LF, Gillion J-F, Jeekel J, Kleinrensink G-J, Lange JF. Primary and incisional ventral hernias are different in terms of patient characteristics and postoperative complications-A prospective cohort study of 4,565 patients. Int J Surg. 2018;51:114-119.
- Bosanquet DC, Ansell J, Abdelrahman T, et al. Systematic review and meta-regression of factors affecting midline incisional hernia rates: analysis of 14 618 patients. PLoS One. 2015;10(9):e0138745.
- Cassar K, Munro A. Surgical treatment of incisional hernia. Br J Surg. 2002;89(5):534-545.
- Sauerland S, Walgenbach M, Habermalz B, Seiler CM, Miserez M. Laparoscopic versus open surgical techniques for ventral or incisional hernia repair. Cochrane database Syst Rev. 2011;(3).
- Olavarria OA, Bernardi K, Dhanani NH, et al. Synthetic versus biologic mesh for complex open ventral hernia repair: a pilot randomized controlled trial. Surg Infect (Larchmt). 2021;22(5):496-503.
- Eker HH, Hansson BME, Buunen M, et al. Laparoscopic vs open incisional hernia repair: a randomized clinical trial. JAMA Surg. 2013;148(3):259-263.
- Kokotovic D, Bisgaard T, Helgstrand F. Long-term recurrence and complications associated with elective incisional hernia repair. Jama. 2016;316(15):1575-1582.
- Pereira JA, Bravo-Salva A, Montcusí B, Pérez-Farre S, Fresno de Prado L, López-Cano M. Incisional hernia recurrence after open elective repair: expertise in abdominal wall surgery matters. BMC Surg. 2019;19:1-6.
- Romain B, Renard Y, Binquet C, et al. Recurrence after elective incisional hernia repair is more frequent than you think: an international prospective cohort from the French Society of Surgery. Surgery. 2020;168(1):125-134.
- Sahm M, Pross M, Hukauf M, Adolf D, Köckerling F, Mantke R. Drain versus no drain in elective open incisional hernia operations: a registry-based analysis with 39,523 patients. Hernia. Published online 2023:1-15.
- Luo Y, Mohammed Jinnaah S, Masood D, Hodgson R. Drain tube use in incisional hernia repair: a national survey. Hernia. 2021;25:427-433.
- Shankar H, Sureshkumar S, Gurushankari B, Sreenath GS, Kate V. Factors predicting prolonged hospitalization after abdominal wall hernia repair-a prospective observational study. Turkish J Surg. 2021;37(2):96.
- Willemin M, Schaffer C, Kefleyesus A, et al. Drain versus no drain in open mesh repair for incisional hernia, results of a prospective randomized controlled trial. World J Surg. 2023;47(2):461-468.
- Miller BT, Tamer R, Petro CC, et al. Retromuscular drain versus no drain in robotic retromuscular ventral hernia repair: a propensity score-matched analysis of the abdominal core health quality collaborative. Hernia. 2023;27(2):409-413.
- Mohamedahmed AYY, Zaman S, Ghassemi N, et al. Should routine surgical wound drainage after ventral hernia repair be avoided? A systematic review and meta-analysis. Hernia. 2023;27(4):781-793.
- Westphalen AP, Araújo ACF, Zacharias P, Rodrigues ES, Fracaro GB, Lopes Filho G de J. Repair of large incisional hernias. To drain or not to drain. Randomized clinical trial. Acta Cir Bras. 2015;30:844-851.
- Louis V, Diab S, Villemin A, et al. Do surgical drains reduce surgical site occurrence and infection after incisional hernia repair with sublay mesh? A non-randomised pilot study. Hernia. 2023;27(4):873-881.
- Bueno-Lledó J, Bonafe-Diana S, Carbonell-Tatay F, Torregrosa-Gallud A, Pous-Serrano S. Component separation and large incisional hernia: predictive factors of recurrence. Hernia. 2021;25(6):1593-1600.
- Van Silfhout L, Leenders LAM, Heisterkamp J, Ibelings MS, Tilburg VHG. Recurrent incisional hernia repair: surgical outcomes in correlation with body-mass index. Hernia. 2021;25:77-83.
- Gignoux B, Bayon Y, Martin D, et al. Incidence and risk factors for incisional hernia and recurrence: retrospective analysis of the French national database. Color Dis. 2021;23(6):1515-1523.
- Moreno-Egea A, Carrillo-Alcaraz A, Aguayo-Albasini JL. Is the outcome of laparoscopic incisional hernia repair affected by defect size? A prospective study. Am J Surg. 2012;203(1):87-94.
Toplam 25 adet kaynakça vardır.
Ayrıntılar
| Birincil Dil | İngilizce |
|---|---|
| Konular | Gastroenteroloji Cerrahisi, Genel Cerrahi |
| Bölüm | Araştırma Makalesi |
| Yazarlar | |
| Yayımlanma Tarihi | 23 Nisan 2025 |
| Gönderilme Tarihi | 1 Ekim 2024 |
| Kabul Tarihi | 17 Ocak 2025 |
| Yayımlandığı Sayı | Yıl 2025 Cilt: 11 Sayı: 1 |
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