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>Journals >Cirujano General >Year 2004, Issue 4


Hernández LA
Simultaneous treatment of wall repair: Use of mesh and intestinal closure
Cir Gen 2004; 26 (4)

Language: Español
References: 24
Page: 242-247
PDF: 4. Kb.


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ABSTRACT

Objective: To demonstrate that the restitution of intestinal transit and wall defect repair with the use of a mesh in one surgical time is possible and safe.
Type of study: Observational, without control group.
Setting: Second level health care hospital.
Patients and methods: Sixteen consecutive patients treated at our unit in the last 5 years. All had abdominal sepsis, it was decided to implement treatment with open abdominal wall and intestinal dysfunctionalization through stomas. When planning the final surgery, patients were included in a preparation protocol to bring them in the best possible condition to the simultaneous repair of both entities (intestinal restitution and wall repair with mesh). Clinical information was collected in a database that included: the disease giving rise to the management, age, gender, preoperative evaluation, preoperative nutritional evaluation, intestinal preparation technique, surgeon, surgical time, number of suture lines at the intestinal level, type of mesh, prosthesis placement technique, use or not of drainage, postoperative complications, re-interventions, hospital stay, and final and current state of the patient.
Results: Sixteen patients were included in the study. All had an abdominal hernia defect and stomas and/or intestinal fistulas. The average of previous surgeries was three, but three patients (cases 8, 11, and 16) had more than six previous surgeries, and five had had only one previous surgery. One patient was excluded during the postoperative period; there were three unsuccessful cases. The remainder of the patients (12 cases) presented a good evolution. Average follow-up was of 3 years and 6 months.
Conclusion: The simultaneous management of intestinal transit restitution and repair of the abdominal wall defect with a mesh, in one surgical time, is feasible in selected patients.


Key words: Abdominal wall, hernia, mesh, abdominal sepsis, hernioplasty.


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