改良疝环充填式无张力疝修补术416例报告

Modified Plug Mesh Tension-free Herniorrhaphy(Report of 416 Cases)

目的探讨为降低术后疝复发率,应用疝环充填式无张力疝修补治疗腹股沟疝术中应采用的方法。方法回顾分析416例疝环充填式无张力疝修补术中网塞和网片的固定方法:①网塞严密固定于周围有抗张力的组织或采用M illikan网塞修补。②网片外缘固定于耻骨梳韧带、腹股沟韧带与髂耻束的交界缘,下端固定于耻骨结节表面的腱膜,内缘固定于腹横肌腱弓和腹外斜肌腱膜的交界缘。③网塞中央花瓣和网片固定。结果416例(440侧)充填式无张力疝修补术,术后平均随访2.5年,无复发。结论改良充填式无张力疝修补术网塞和网片的固定方法是降低术后复发的有效措施。

Objective To discuss the clinical experience of preventing hernia relapse after Plug Mesh tension-free herniorrhaphy. Methods Fixation methods of Plug and Mesh in 416 cases were retrospectively analyzed. ①Plug were exactly fixed on amphi-compact tissue or Millikan modified mesh-plug hernioplasty. ②Exterior margin of Mesh was sutured at borderline of pectineal ligament, inguinal ligament and iliopubic tract. Inferior extremity of Mesh was fixed superficial aponeurosis of pubic tubercle. Inner margin of Mesh was fixed on the border of transverse abdominal musculotendinous cuff and oblique externus abdominis muscle aponeurosis. ③Mesh was fixed to central petal of Plug. Results No relapse of inguinal hernia in all these 416 patients who were followed up mean time of 2.5 years. Conclusion Better fixation of Plug and Mesh is good for preventing hernia relapse after Plug Mesh tension-free herniorrhaphy.