前腹壁疝手术治疗的问题与挑战。审查

T. Tarasiuk
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摘要

这篇文献综述讨论了前腹壁疝手术治疗中出现的争议性问题和挑战。作者确定了疝形成的原因,并检查了疝发生模式的变化动态。分析了导致切口腹疝发展的因素,并给予了特别的考虑。并对疝复发的原因进行了探讨。回顾了现有的原发性和切口腹疝的分类,以及它们的优点和缺点。对目前关于使用额外影像学方法检查腹疝患者的建议进行了评估。在本研究中,对疝的手术治疗方法给予了相当的重视。对“开放”和微创腹腔镜疝成形术的优缺点进行了批判性评估。对于某些类型的疝气,包括大疝气,选择干预方法的困难,以及预防疝气复发的重要性被强调。研究表明,腹壁前疝的外科治疗仍有许多未解决的问题。作者认为需要一种标准化的方法来确定前腹壁疝的特征及其进一步的分类。有必要根据腹疝的大小和位置,研究使用影像学方法(超声、计算机断层扫描)治疗腹疝的有效性。腹腔镜疝成形术需要更广泛的应用,在确定手术干预的指征时应考虑疝缺损的程度。腹腔镜疝成形术治疗大疝的可能性,以及与腹直肌分离相关的疝,需要进一步的研究。改善前腹壁疝患者的治疗策略对于降低疝复发和并发症的风险至关重要。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Issues and challenges in the surgical treatment of anterior abdominal wall hernias. Review
The literature review discusses contentious issues and challenges that arise in the surgical treatment of anterior abdominal wall hernias. The author identified the causes of hernia formation and examined the dynamics of change in the pattern of hernia incidence. An analysis of the factors that contribute to the development of incisional ventral hernias was given special consideration. The causes of hernia recurrence were also studied. The entire spectrum of existing classifications of primary and incisional ventral hernias was reviewed, along with their advantages and disadvantages. Evaluation of current recommendations regarding the use of additional imaging methods for the examination of patients with ventral hernias was carried out. In the study, considerable attention was paid to surgical methods for hernia treatment. The advantages and disadvantages of “open” and minimally invasive laparoscopic hernioplasty techniques were critically evaluated. The difficulties in selecting an intervention method for certain types of hernias, including large ones, were highlighted, as was the importance of preventing hernia recurrence. It has been established that there are still many unsolved problems in the surgical treatment of anterior abdominal wall hernias. The author justified the need for a standardized approach to determining the characteristics of anterior abdominal wall hernias and their further classification. It is necessary to study the effectiveness of using imaging methods (ultrasound, computed tomography) for ventral hernias, depending on their size and location. There is a need for wider implementation of laparoscopic hernioplasty techniques, and the degree of the hernial defect should be taken into account when determining the indications for surgical intervention. The possibility of using laparoscopic hernioplasty for large hernias, as well as for hernias associated with rectus abdominis diastasis, requires further investigation. Improving management strategies for patients with anterior abdominal wall hernias is critical in order to reduce the risk of hernia recurrence and complications.
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