[Mayo duplication in treatment of incisional hernia of the abdominal wall after conventional laparotomy. Results of a retrospective analysis and comparison with the literature].
About 10% of patients undergoing conventional laparotomy will develop incisional hernias. Traditionally these hernias are in this country most often repaired by a Mayo-duplication. In this retrospective analysis we investigated a consecutive series of 114 patients (mean age: 53 (11-87) years, gender ratio m:f 1.2:1.97% electively operated) with 135 hernias, operated between 1/1985 and 12/1992 by a standard Mayo-procedure. Recurrence-rates and quality of life were evaluated by clinical examination. The mean follow-up time was 5.7 (2.5-10.2) years with a follow-up rate of 84.4%. The overall recurrence rate was 53.5%. Further uni- and multi-variate analysis was unable to find any clinically relevant risk factors for hernia development. Health related quality of life was evaluated with a validated index at the time of their follow-up visit. There were no differences in patients without a hernia recurrence (n = 52) when compared to those with an actually present recurrence (n = 36). However, physical function of all patients was significantly impaired when compared to healthy individuals. According to our results and those reported by others the Mayo-duplication when applied to all patients leads to non-acceptable results and implantation of auto- or alloplastic material should be considered more frequently.
Paul
A
A
II. Lehrstuhl für Chirurgie, Universität zu Köln, Städtisches Krankenhaus Köln-Merheim.
Korenkov
M
M
Peters
S
S
Fischer
S
S
Holthausen
U
U
Köhler
L
L
Eypasch
E
E
D000009:Abdominal Muscles / Q000601:surgery*; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006555:Hernia, Ventral / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000601:surgery*; D011788:Quality of Life; D012008:Recurrence; D012086:Reoperation; D013536:Suture Techniques