开放式后入路无张力修补老年双侧腹股沟疝24例报告

Posterior approach for bilateral inguinal hernia in the elderly:a report of 24 cases

目的探讨开放式后入路无张力修补术在老年双侧腹股沟疝治疗中的临床应用价值。方法对2004年9月至2006年10月24例行开放式后入路无张力修补的双侧老年腹股沟疝病例的手术时间、术后并发症、住院时间、复发情况进行回顾性分析。结果平均手术时间65min，并发症发生率16．7％（4／24），平均住院时间4．5d。随访3个月～2年，无术后复发。结论采用开放式后人路方法进行老年双侧腹股沟疝无张力修补术，符合老年双侧腹股疝的解剖特点和“个体化”要求，具有操作简便、手术费用低等特点，同时减少了手术损伤，易于广泛推广。

Objective To investigate the clinically applied value of posterior approach for bilateral inguinal hernia in the elderly patients. Methods Data of 24 cases of bilateral inguinal hernia treated through a posterior approach from September 2004 to October 2006 were analyzed retrospectively,including operative time, postoperative complications, hospital stay and recurrent rate. Results Herniorrhaphies for bilateral inguinal hernia were performed on 24 subjects with a mean age of 68.4 years （range 60-87）. There was 19 cases of primary bilateral inguinal hernia （79.2%） and 5 cases of recurrent one （20.8 % ） respectively. Eighteen cases were complicated with other diseases （75.0 % ）. The incidence of postoperative complication was 16.7 %, mean operative time was 65 min, mean hospital stay was 4.5 days. During a follow - up period of 3 months to 2 years, no recurrence occurred. Conclusion The posterior approach in repairing bilateral inguinal hernia is accordance with pathogeny of the inguinal area and individualization in the elderly patients. It has characteristics of simplicity,low- cost and security.