局麻下超普网片Lichtenstein无张力疝修补术治疗腹股沟疝合并肝硬化腹水的体会

Clinical experience of Lichtenstein hernia repair with ultrapro-mesh under local anesthesia for pa-tients with liver cirrhosis accompanied by ascites

目的 探讨局麻下用超普网片行Lichtenstein无张力疝修补术治疗合并肝硬化腹水腹股沟疝患者的安全性及有效性.方法 回顾分析我院2007年3月至2011年7月用超普网片行Lichtenstein无张力疝修补术治疗合并肝硬化腹水腹股沟疝患者25例,对其手术效果进行分析评估.结果 所有患者均顺利完成手术,平均手术时间52.3min.术后2例出现阴囊血肿,1例切口皮下积液,没有出现较严重并发症如腹水漏出及感染.术后平均住院时间9.1d.术后随访12～35个月,平均17.6个月,随访期内无手术部位疝复发,但有2例新发生其他部位腹壁疝.结论 局麻下用超普网片行Lichtenstein无张力疝修补术治疗合并肝硬化腹水腹股沟疝患者安全、有效,可以明显提高生活质量.

Objective To evaluate the safety and efficacy of Lichtenstein hernia repair with ultra- pro-mesh under local anesthesia for patients with liver cirrhosis accompanied by ascites. Methods The medical records of 25 patients with cirrhosis and ascites who underwent Lichtenstein hernia repair with ul-trapro-mesh under local anesthesia from March 2007 to July 2011 were retrospectively reviewed, and the surgical outcomes of these patients were analyzed. Results Surgery was successfully performed under lo- cal anesthesia in all patients and the mean surgical time was 52.3 min. There were 3 cases of postoperative complications,including 2 cases of scrotal hematoma and 1 case of subcutaneous hydrops in incision. There was no case of serious complications, such as ascites leak or wound infection. The mean postoperative length of hospital stay was 9.1 days. The postoperative follow-up was 12-35 months,with an average time of 17.6 months. There was no recurrence at the operative site, but 2 case of recurrence occurred at the non operative site. Conclusion The Lichtenstein hernia repair with uhrapro-mesh under local anesthesia for patients with live cirrhosis accompanied by ascites is safe and effective, which can significantly improve quality ot lite.