改良Kugel腹股沟疝修补术治疗腹股沟疝的探讨

To approach the treatment of inguinal hernia with modified Kugel

目的探讨改良Kugel腹股沟疝修补术在腹股沟疝治疗中的理论基础和临床应用价值。方法采用Bard Modified Kugel Hernia Patch(内存记忆弹力环改良Kugel补片)行改良Kugel腹股沟疝修补术腹股沟疝102例,以手术时间、术后患者自主能力的恢复、并发症的发生、复发率及术后住院时间作比较。结果手术时间45～110 min,平均55 min。术后2～6 h患者即可起床活动和进食,切口疼痛和不适轻,无明显异物感,活动时腹股沟区无牵拉感,无并发症,平均住院时间5 d。随访无1例复发。结论改良Kugel腹股沟疝修补术是应用经腹股沟管前入路行腹膜前腹股沟疝修补的技术,针对耻骨肌孔进行修补,利于解决耻骨肌孔结构薄弱及缺损这一腹股沟疝发生的解剖学基础,具有手术彻底、术后恢复快、并发症少、复发率低的优点,从根本上解决腹股沟疝患者多种疝并存及容易复发的病理生理特点,是目前腹股沟疝治疗中较理想的手术方式。

Objective To discuss the theoretical foundation and clinical application of the modified Kugel inguinal hernia repair. Methods Using the Bard Modified Kugel Hernia Patch in modified Kugel ingninal hernia repair for 102 cases, then to observe the operation time, recovery of independence, complications, recurrence rate and hospital stay. Results The operative time was ranged from 45 to 110 minutes （ mean 55 minutes）. 2 to 6 hours after operation, patients can get up and eat, the incision pain and discomfort was light, the average length of stay was five days and no foreign body sensation, no sense of traction, no complications, no follow-up recurrence. Conclusions modified Kugel inguinal hernia repair is anterior approach preperitoneal repair for inguinal hernia, conducive to resolving the weakness of myopectineal orifice which is the anatomical basis of inguinal hernia, it is a fundamental resolution to the pathophysiological characteristics of a variety of hernia co-exist and recurrence easily, so it is a better repair with the advantage of thorough treatment, recovery rapidly, fewer complication, and lower recurrence.