重视疝和腹壁外科疾病规范化治疗

Attention to the standardization of treatment of hernia and surgical diseases of abdominal wall

近15年来疝和腹壁外科在中国的发展非常迅速,新概念、新技术、新材料的不断更新也是促进该领域快速发展的重要因素。目前,无张力腹股沟疝修补技术已经普及到县级基层医院,曾经认为治疗非常困难的疝(如切口疝、造口疝、食管裂孔疝等)也获得了远比以往更理想的疗效。每年应用新技术、新材料进行外科手术的例数已达几十万例,这对该领域的发展起到了积极推动作用。但随着病例数的增加,概念的混乱、技术应用不规范、材料选择不当、并发症(尤其是严重并发症)发生率增加等问题随之显现。为此,有必要以规范化治疗为重点,对该领域存在的问题进行讨论,以加强外科医生对疝和腹壁外科的重视。

Hernia and abdominal wall surgery has been developing fast in the past 15 years due to the solid foundation laid by the elder generation. Meanwhile, the emerging of new concept, new technology and new mesh material is the other driving factor in the field. Presently the tension-free inguinal hernia repair is universal in county level hospitals. Other special and difficult hernia including ventral hernia, parastomal hernia and hiatal hernia have achieved much better treatment effect as well. The total procedures reached around half million with new technology and new mesh material involved, which is the positive momentums absolutely in the field. However, something still developed unbalance. With the procedure number increasing, some problems are getting more obvious, such as concept misunderstanding, improper mesh selection, less standardized technology and more complications. Therefore, it＇ s crucial to discuss and set the standardized treatment guideline for the further efforts for hernia and abdominal wall surgery.