The Clinical Application Analysis To Compare The Open Techniques Of Onlay And Sublay In Abdominal Incision Hernia Repair

Objective:To evaluate the clinical effect of two different operation methods in thetreatment of abdominal incisional hernia.Methods:The clinical data were reviewed retrospectively of21patients withabdominal incisional hernia. The sample come from patients who got treated in TheFirst Affiliated Hospital of Dalian Medical University in the period from Apr.2005toDec.2011.8cases in the sample were treated in the operation method of onlay, whilethe other13cases were treated in the method of sublay. Make clinical analysis ofoperative time, postoperative hospitalization time, postoperative complications andrecurrence rate of both teams.Results:The operations of all21cases were completed successfully, withoutsevere postoperative complications. All the21patients were cured after treatment. Theoperative time is:53～112min of group onlay, with a mean time of72min;75～176minof group sublay, with a mean time of120min. Postoperative hospitalization time is:8～18d of group, with a mean time of12.6d;6～15d of sublay, with a mean time of9.5d.The postoperative complications are: one case of lung infections (in group sublay), onecase of urinary tract infections (in group onlay),one case of seroma (in group onlay),3cases of incision fat liquefaction (2cases in group onlay and1case in group sublay).All the cases of postoperative complications were cured after conservative treatment.There is no case with postoperative complications of respiratory failure or intestineobstruction and no operative death case. The clinical following-up study of all21patients was ranged from3to64months, with an average of35.6months. In the resultof follow-up,2patients complain abdominal wall foreign body sensation (both in grouponlay), and3patients complain chronic postoperative pain (2cases in group onlay,1 case in group sublay). All these cases got alleviated after conservative treatment. Thereare2recurrence cases in group onlay of8cases, while no recurrence case in groupsublay of13cases.Conclusion:Sublay herniorrhaphy is a safe and effective operation method in thetreatment of abdominal incisional hernia. It is obvious superior to onlay herniorrhaphyin aspects of less pain, quicker recovery, fewer postoperative complications and lowerrecurrence rate. It is worth extending in clinical practice.