Study On The Application Of Synthetic Materials For Abdominal Wall Hernia Tension-Free Repair After Patch Related Occult Intestinal Fistula

Background Tension-free hernia repair with its simple operation, small trauma, quick recovery, low recurrence rate, has been widely applied in the world. But with the increase of the application number of cases, such as postoperative infection, chronic pain, seroma, intestinal fistula etc. complications is often visible reports, and patch related intestinal fistula is tension-free hernia repair after the most severe complications. Pieces of intestinal fistula clinical manifestations mainly patch delayed deep infection, by sinus radiography, abdominal CT, MRI and other imaging examination can diagnosis, surgery can also was found in the intestinal fistula. But with the increase of clinical cases, we found and a special patch related fistula. The fistula clinical first for patch delayed infection, but preoperative found no intestinal fluid overflow, sinus radiography is no contrast agent into the intestine, in surgical removal of the infected patch also found no symptoms of intestinal fistula, but after the operation showed obvious symptoms of intestinal fistula. The occurrence of the fistula, due to pre- and postoperative, no obvious clinical manifestations, we can call it as patch related occult intestinal fistula.ObjectiveTo the cause, diagnosis, treatment and prevention of synthetic materials for abdominal wall hernia tension-free repair patch related occult intestinal fistula.Methods Collected Shaanxi Provincial People’s Hospital of general surgery department 2003-2014 a total of 36 cases of abdominal wall hernia tension-free hernia repair mesh infection after patients, which 5 cases after removal of the infected patch repair occurred patch related occult intestinal fistula cases, patch related hidden causes of intestinal fistula, diagnosis, treatment and prevention of a retrospective analysis.Results 5 cases of this group of patients, in the abdominal wall hernia tension-free repair occurred infection of the patch, occurrence time in postoperative 3 months to10 years, 5 cases of this case were in surgical removal of infected patch of 24-72 hours after drainage found intestinal fluid, intestinal fistula, intestinal fistula is about15-40ml/d. Intestinal fistula after 5 cases were not surgery, in giving sufficient drainage, anti infection and nutrition support after recovery, followed up for 3 months without exception.Conclusion Abdominal wall hernia tension-free hernioplasty patch related occult intestinal fistula occurred, due to the initial clinical manifestation of only patch delayed deep infection and imaging examination can not be found, therefore it is difficult to be detected early, the sinus drainage liquid bacterial culture results for intestinal flora can be to extrapolate the possible patch related occult intestinal fistula,the diagnosis needs postoperative drainage tube see intestinal juice. The possible causes of morbidity and patch erosion of the intestine, but also can not rule out the operation factors of surgery. For the treatment, conservative treatment, adequate drainage is a necessary condition for the healing of intestinal fistula. Prevention patch related occult intestinal fistula, mainly from its etiology and prevention, how to prevent the patch on intestinal erosion is the key to prevention, in addition to remove the infected mesh graft careful operation, to avoid bowel injury also should be paid attention to.