精索和圆韧带脂肪瘤93例临床分析

Analyses of spermatic cord and round ligament lipoma(93 cases of report)

目的探讨精索和圆韧带脂肪瘤及其相关临床问题。方法总结我院2005年9月至2008年6月收治的610例腹股沟疝患者中发现精索和圆韧带脂肪瘤患者93例。常规行无张力修补疝(重建内环)切除脂肪瘤。结果本组共切除脂肪瘤132枚,1～7枚/人。单个瘤体最大15 cm×10 cm×3 cm,最小1 cm×1 cm×1 cm。术后行病理检查77例,检查率82.8%。光镜下病理类型:脂肪瘤33例、血管脂肪瘤19例、纤维脂肪瘤6例以及脂肪瘤样增生19例。补片感染1例,于术后3个月将补片取出。术后随访2～35个月,无脂肪瘤复发及所致疝复发。结论精索和圆韧带脂肪瘤可以产生临床内环扩大或疝,应予以手术切除。由于缺乏特异性临床表现和医师对本病的忽视,本病的实际发病率可能要高于本组在疝手术时的发病率。切除精索和圆韧带脂肪瘤不增加无张力疝修补的难度,手术是安全的,术后恢复顺利。

Objective To investigate the spermatic cord lipoma and related clinical concerns. Methods Totally 93 cases of spermatic cord and round ligament lipomas in 610 patients with a routine in- guinal hernia repair from September 2005 to June 2008 were enrolled. The lipomas were removed and hernias were repaired by tension-free repair （ reconstructing inner ring ）. Results A total of 132 cases of resected lipoma were＇ removed ,The single tumor with maximin volume of 15 cm × 10 cm × 3 cm and minimum volume of 1 cm × 1 cm × 1 cm. Pathological examination were performed in 77 cases after operation with inspection rate of 82.8%. The common pathological types by light microscope included lipoma （33）, telangiectatic lipoma （19） ,fibrolipoma （6） and lipoma-like proliferation （19）. Patch infection occurred in one case and the patch was removed 3 months after operation with a follow-up of 2 to 35 months and no recurrence of lipema and her - nia was observed. Conclusions Spermatic cord and round ligament lipoma can cause inner ring to expand or hernia and should be removed by surgery. Due to lack of specific clinical manifestations and neglection by surgeons, the actual incidence of disease may be higher than the ratio found in this group with hernia repair . Removing lipomas is safe with satisfied postoperative recovery.