无张力疝修补术治疗成人腹股沟绞窄疝6例

Tension-free hernia repair in adult inguinal strangulated hernia:a report of 6 cases

目的探讨无张力疝修补术治疗成人腹股沟绞窄疝的应用及效果。方法回顾性分析成都军区总医院全军普外中心胃肠病区在2008年7月至2010年7月应用无张力疝修补术治疗6例腹股沟绞窄疝患者的临床资料,入选病例均以术中证实为小肠绞窄坏死但未穿孔为标准,同期行小肠部分切除吻合与无张力疝修补。结果本组病例全部治愈,补片外血浆引流管放置时间42～81h,平均60.5h,住院时间7～12d,平均8.6d。胃肠功能恢复时间26～61h,平均46h,未出现腹腔感染,积脓,切口感染,补片排斥反应及阴囊积液等并发症。6例病例中有5例获得随诊,随诊时间2～21个月,平均12个月,无复发。结论成人腹股沟绞窄疝可成功一期无张力修补,不应作为绝对手术禁忌证,但应注意病例的选择。

Objective To discuss the clinical application and effect of tension-free hernia repair in adult inguinal strangulated hernia.Methods Six patient＇s clinical data with tension-free hernia repair in adult inguinal strangulated hernia were analysed retrospectively from July,2008 to July,2010.All cases were with small intestine necrosis but not perforated.The small intestine were excised partially and with hernia repaired at the same time.Results All cases were cured completely,blood plasma drainage tube laying aside time from 42 to 81 hours,hospital stay time from 7 to12 days.The gastrointestinal function restore time from 26 to 61 hours.There were no complications like the abdominal cavity infection,empyema,incisional infection,rejection reaction of patch,scrotal hydrocele and so on.Five cases were followed up with 2 to 21 months,average was 12 months,no recrudescence was found.Conclusions Adult inguinal strangulated hernia with tension-free repair should not be the ab-solute surgical contraindication,but should pay attention to choice the case.