无张力疝修补术治疗老年腹股沟疝的临床分析

Application of Tension-free Hernioplasty in Inguinal Hernia in the Elderly

目的 评价无张力疝修补手术治疗老年人腹股沟疝的疗效。方法 回顾性分析 10 5例老年腹股沟疝行无张力疝修补手术的临床资料。结果 10 5例老年患者共施行了 12 3次无张力疝修补术 ,其中 83次行疝环充填式无张力疝修补术 ,4 0次行Lichtenstein手术 ,单侧疝及双侧疝平均手术时间分别为 36min ,73min。术后并发症仅 1例小的皮下血肿 ,无切口感染 ,无围手术期死亡。腹股沟疝患者均于术后 3～ 9d痊愈出院。 75 % (79/10 5 )病例获得随访 ,随访时间 5～ 5 0个月 ,无术后复发 ,仅 1例有腹股沟区疼痛。结论 采用无张力疝修补手术治疗老年人腹股沟疝是安全的 ,其并发症少 ,复发率低 ;对双侧腹股沟疝的患者可同期进行手术 ,避免再次手术。

Objective To evaluate the therapeutic effect of tension-free hernioplasty on inguinal hernia in the elderly patients. Methods The clinical data of 105 cases of inguinal hernias undergoing tension-free hernioplasty were retrospectively analyzed. Results 123 open tension-free hernia repairs in 105 elderly patients were performed, including mesh plug tension-free hernioplasty (83 times) and Lichtenstein operations (40 times) according to the diameters of internal ring and degree of weakness of the transversalis fascia. The average time of operation in unilateral and bilateral hernias was respectively 36 min and 73 min. Postoperative complications included small hypoincisional haematoma only in one case. No wound infection and mortality occurred. All patients were discharged 3-9 days after operation. 75 % (79/105) of patients were followed up for 5 to 50 months. During the follow-up there was one case with chronic pain in the groin and no recurrence was found. Conclusion Open tension-free hernia hernioplasty for the treatment of inguinal hernia in the elderly and simultaneous bilateral repair for the patient with bilateral inguinal hernias are safe and reliable methods. Individualized operation for hernia is beneficial to obtain better therapeutic effect and reduce recurrence rate.