Zeng Tian,Li Xinning,Huang Jingjing,et al.Efficacy of allogeneic acellular dermal mantrix in repairing giant omphalocele[J].Journal of Clinical Pediatric Surgery,,19():306-309,316.[doi:10.3969/j.issn.1671-6353.2020.04.005]
Efficacy of allogeneic acellular dermal mantrix in repairing giant omphalocele
- Keywords:
- Hernia; Umbilical/DI; Hernia; Umbilical/SU; Tissue Engineering; Reconstructive Surgical Procedures
- CLC:
- R657.7;R318;R628
- Abstract:
- Objective To summarize the therapeutic experiences of giant omphalocele with human acellular dermal mantrix.Methods Thirty-one cases of giant omphalocele were treated with human acellular dermal mantrix from March 2014 to November 2019.There were 18 boys and 13 girls with a body weight of (1.8-3.5) kg and with an abdominal wall defect of >5 cm.The presenting time was 1 h-1 d after birth.Operation was completed within (3-12) hours.All 31 cases had small intestine,colon and liver in amniotic sac.There were congenital heart disease (tetralogy of Fallot,ventricular septal defect,atrial septal defect & patent ductus arteriosus) (n=12),21-trisomy (n=1),polydactyly (n=1),intestinal atresia (n=1),Meckle’s diverticulum (n=2) and intestinal malrotation (n=3).Amniotic sac was excised intraoperatively.Cases of heart malformation were observed and left untreated.Polydactyly was re-operated for removing extra fingers after several months.Meckel’s diverticulum and intestinal patency were observed conservatively.For intestinal atresia,intestinal resection and anastomosis were performed.Ladd’s correction was performed for intestinal malrotation.During omphalocele repair,peripheral muscle tissue of umbilical cord defect was separated and then biological patch sutured with muscle for repairing defect.Umbilical cord was formed ultimately.After operation,ventilator-assisted ventilation was performed for 2-5 days and milk was provided gradually after 1 week.The follow-up period was one year after discharge.Results All 31 cases were cured and discharged from hospital.In 1 case of patch rejection,there were recurrent fever,wound exudate and wound dehiscence.However,there were improvements after symptomatic treatment.Two cases of umbilical cord wound healed poorly and formed a large scar filling.In 1 case of abdominal hernia,abdominal volume expansion was not satisfactory and umbilical mass became prominent.So re-operation was performed.Two cases of postoperative intestinal obstruction improved after conservative measures.Conclusion For giant omphalocele,biological patch repair is an ideal treatment with excellent compatibility,fewer adverse reactions or complications and faster postoperative recovery.
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Memo
收稿日期:2019-12-22。
基金项目:广西壮族自治区卫生健康委员会自筹经费科研课题（编号：Z20190899）
通讯作者:李新宁,Email:zest519@126.com