无张力腹股沟疝修补术后疝复发的临床分析

An analysis of hernia recurrence after tension free inguinal hernioplasty

目的 探讨无张力腹股沟疝修补术后疝复发的原因、预防及治疗。方法 结合 11例无张力腹股沟疝修补术后复发疝的临床资料 ,分析其复发的原因 ,并提出改进手术的方法及对复发疝的治疗。结果 本组 10例 ,其中疝环充填式无张力疝修补术后复发 6例 ,平片修补术后复发 4例。复发原因为平片修补术后因补片过小复发 1例 ,补片卷曲、移位 1例 ,补片精索孔留得过大 2例 ,疝环充填式无张力疝修补术后充填之网塞未牢靠固定在疝环口周围的坚韧组织上复发 2例 ,疝环口过大 ,与充填之网塞不匹配 2例 ,充填的 2个网塞之间未固定 ,留有间隙 1例 ,网塞间断缝合固定 ,但网片未固定 1例。结论 无张力腹股沟疝修补术后复发疝的原因主要是术中操作失误即对网塞和补片的置入和固定不当 ,其治疗方法仍为开放的无张力腹股沟疝修补术 ,主要是疝环充填式无张力疝修补术。

Objective To investigate the causes of hernia recurrence after tension free inguinal hernioplasty and its prevention and treatment Methods The clinical data of 10 hernia recurrence cases were retrospectively analyzed Results There were 6 recurrent cases after mesh plug tension free hernioplasty and 4 cases after Lichtenstein repair The causes of recurrence included too small for size of the mesh, mesh was coiled and migrated, too large holes of mesh left for spermatic cord, mesh plugs not properly fixed, internal rings too large miss matching the mesh plug, two mesh plugs not mounted together, etc Conclusion The main causes of recurrent hernia after tension free inguinal hernioplasty were related with failure in applying correct operative techniques, the recurrence needs open mesh repair, especially mesh plug tension free hernioplasty