经腹直肌入路腹膜前间隙无张力疝修补术在嵌顿疝中的应用

Tension-free hernia repair via a rectus abdominis incision to treat the inguinal incarcerated hernia

目的探讨经腹直肌入路腹膜前间隙无张力疝修补术在嵌顿疝中的应用价值。方法采用经腹直肌入路腹膜前间隙无张力疝修补术治疗嵌顿疝37例。其中腹股沟斜疝31例,直疝2例,股疝1例,腹股沟斜疝合并直疝3例。结果本组患者手术时间45～65min,平均(56±10)min;住院时间7～11d,平均(8.7±1.9)d。术后无补片相关并发症发生。随访6个月至3年无复发。结论经腹直肌入路腹膜前间隙无张力疝修补术在腹股沟嵌顿疝中的应用效果确切,并发症少,操作简便安全,尤其适用于腹横筋膜薄弱或缺损严重的患者,值得临床推广。

Objective To explore the application of preperitioneal tension-free hernia repair by rec- tus approach in incarcerated inguinal hernia gap. Methods A total of 37 cases with incarcerated inguinal hernia were treated with preperitoneal tension-free hernia repair by the rectus approach. Of them,31 cases of inguinal hernias,2 cases of direct hernias, 1 cases of femoral hernia, and 3 cases complicated with direct her- nias were included. Results The operation lasted 45 to 65 minutes with a mean of （56 ± 10） rains and the hospital stay was 7 to 11 days with a mean of （8.7 ± 1.9 ） days. No patch related complication and recurrence were observed in the follow-ups from 6 months to 3 years. Conclusions The preperitioneal tension-free hernia repair by rectus approach in incarcerated inguinal hernia gap is effective and safe with few complications, especially for the patients with serious defects of trasversalis fascia.