[The repair of recurrent postoperative incisional hernias. Objectives and therapeutic indications (68 cases)].
Among 327 surgical repairs of incisional hernias done between 1974 and 1989, 68 repairs (21%) were performed because of a primary treatment failure. Failed primary attempts of cure had been unique in 71%, and multiple in 29% of cases; their procedure had been essentially suture or herniorrhaphy. Site of recurrent incisional hernia (R.I.H.), was midline or lateral incision in respectively 84% and 16% of cases. Size of R.I.H. was considered as large in two third of cases. Operation was performed electively in majority of cases (93%). More than half of the patients were "prepared" by preoperative pneumoperitoneum and/or weight reducing regimen. Mersilene* mesh was used in 81% of cases. Results of treatment of R.I.H. are reported, depending on procedure. Among 55 cures by use of Mersilene* mesh, 1 patient died (from myocardial infarction), and 5 recurrences occurred, 4 of which from sepsis. Study of complications and failures suggests: 1) careful attention to indications, 2) advantages of a large size Mersilene* mesh, 3) attention to preoperative treatment, especially weight loss regimen and progressive pneumoperitoneum.
Champetier
J
J
Service de Chirurgie Générale et de Chirurgie Digestive, C.H.U. de Grenoble, Hôpital Nord.
Letoublon
C
C
Chaland
P
P
Alnaasan
I
I
Bouchard
F
F
Granger
P
P
D000328:Adult; D000368:Aged; D001705:Bioprosthesis / Q000009:adverse effects; D005260:Female; D006555:Hernia, Ventral / Q000209:etiology / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011028:Pneumoperitoneum, Artificial; D011093:Polyethylene Terephthalates; D011183:Postoperative Complications; D011184:Postoperative Period; D019736:Prostheses and Implants / Q000009:adverse effects; D012008:Recurrence; D018805:Sepsis / Q000209:etiology; D013537:Sutures / Q000009:adverse effects
D011093:Polyethylene Terephthalates
La cure des éventrations abdominales post-opératoires récidivées. Objectif et indications thérapeutiques (68 cas).