无张力疝修补术在腹股沟嵌顿疝中的临床应用

The clinical application of tension-free hernioplasty on the treatment of incarcerated inguinal hernia

目的探讨无张力疝修补术在腹股沟嵌顿疝中的临床应用价值。方法使用美国外科公司的疝修补塞及补片,对21例腹股沟嵌顿疝患者施行无张力疝修补术,观察其疗效。结果手术平均时间50分钟,平均住院时间4天,术后4￣6小时即可下床活动;48小时后切口疼痛3例(14.29%),局部轻微隆起异物感4例(19.05%),睾丸肿胀2例(9.52%)。全组均Ⅰ期愈合(100%),无切口感染及阴囊血肿发生,随访1￣16个月无复发。结论应用无张力疝修补术治疗腹股沟嵌顿疝是安全有效的,是较理想的术式,具有操作简单,术后疼痛轻,恢复快,住院时间短,并发症少,复发率低等优点,远期疗效尚待观察。

Objectives To assess the clinical value of tension-free hernioplasty for the treatment of incarcerated hernia. Methods 21 cases of incarcerated inguinal hernia patients underwent tension-free hernioplasty, using bungs and patch produced by American surgical company. Patients were followed-up from 1 to 16 months postoperatively. The curative effect was recorded. Results The mean operation time was 50 minutes; the mean hospital stay was 4 days. Patients might walk around 4-6 hours postoperatively. The main morbidity included local pain on the incisions after 48 hours postoperatively （3 cases, 14.29%）, slight local foreign body sensation （4 cases, 19.05%）, testis tumefaction （2 cases, 9.52%）. All incisions achieved phase I concrescence. No incision infection and scrotum haematoma were observed postoperatively. No recurrence was found during the follow-up period. Conclusion The technique of tension-free hernioplasty is an ideal alternative for the treatment of incarcerated hernia, with litde postoperative comphcation, short hospital stay and low recurrent rate. The longer-term follow up is needed for evaluating the durability.