疝环充填式无张力疝修补术治疗腹股沟疝

Clinical application of polypropylene mesh and plug in groin hernia repair

目的探讨聚丙烯网塞及补片在腹股沟疝修补术中的优点、并总结经验教训。方法采用美国巴德公司的聚丙烯锥形填充物及成型补片对216例腹股沟疝病人施行疝环填式无张力疝修补术,观察手术时间,伤口疼痛,术后自主能力恢复,并发症及复发率。结果手术时间平均为45min;术后3～8h病人能下床活动;伤口疼痛时间2～3d。术后排尿困难3例,切口血肿1例,无一例切口感染。腹股沟异物感10例,睾丸炎1例。术后随访6～96月206例,仅1例复发,复发率0.45%。结论锥形填充物及成型补片组织兼容性好,无排异反应,具有一定的抗感染能力,是理想的疝修补材料。疝环填充式无张力修补术,手术操作简便,损伤轻,恢复快,并发症少和复发率低,手术指征可适当放宽,是较先进的疝修补术式。

Objective To explore the advantages and summarize the experience of tension - free hernia repair with mesh and plug. Methods 216 patients with groin hernia were applied with Bard mesh ＆ Perfix plug offered by Bard Company in USA. The operation time, postoperative pain, recovery ability of patients, complications and recurrence rate were analyzed retrospectively. Results The average operation time was 45 minutes, patients could get up within 3- 8 hours after the operation; and postoperative pain lasted about 2 - 3 days. Three cases had retention of ufine, and one with persistent wound pain, No wound infection occurred. Ten cases had feeling of foreign matter in groin region. One had testitis after operation. 206 cases were followed up for 6 - 96 months, and recurrence was found only in one case. Condusion Bard mesh ＆ Perfix plug have good tissue - compatibility, capability of anti - infection and no rejection. They are ideal material for hernia repair. Tension - free hernia repair with mesh and plug is easy to be performed and it has advantages of minor trauma, quicker recovery and lower recurrent rate. The indication for this kind of operation should be widened. It is one of the most advanced methods in treatment of groin hernia,