单丝聚丙烯纺织补片治疗腹股沟疝的临床应用体会

Clinical application of Modified Kugel in treatment of inguinal hernia

目的探讨单丝聚丙烯纺织补片治疗腹股沟疝的技术操作要点,并评价其临床疗效。方法回顾性分析2005年1月至2012年7月上海市杨浦区中心医院应用单丝聚丙烯纺织补片行开放性前入路腹膜前修补治疗腹股沟疝患者563例的临床资料。结果本组患者平均手术时间(40±15)min,平均住院时间(120±48)h,术后患者切口仅有轻微疼痛,均口服镇痛药。术后1～36h下床活动,有3例皮下及阴囊血肿、积液,经保守治疗后痊愈。无切口感染及腹股沟区无明显异物感。全组随访3～90个月,复发1例,1例术后28d出现粘连性肠梗阻再手术,行部分小肠切除术,术后恢复良好,痊愈出院。结论单丝聚丙烯纺织补片在腹股沟疝无张力修补术中实现了"全腹股沟区"的增强修复,是一种安全有效、术后恢复快和疗效满意的治疗方法。

Objective To identify the key point of the herniorrhaphy procedure with Modified Kugel, and to evaluate its clinical effectiveness. Methods A retrospective study was performed to analyze clinical data in a total of 563 patients with inguinal hernia who received open-preperritional tension-free herniorrhaphy with Modified Kugel between January 2005 and July 2012 in our hospital . Results The mean operating time was（40 ：L 15） rains. The average length of hospital stay（ 120 ~48）h. Most of patients just had slight pain, which could be received with NSAIDs. Patients stayed in bed for 1 to 36 hours after operations. Scrotum hematoma and hydroceles were occurred in 3 cases and recovered. There was no incision infection and discomfort in the mouths of inguinal region. During the follow-up of 3 to 90 months, one case was relapsed and another case was occurred with adhesive intestinal obstruction in the 28th day after operation, who recovered by partial resection of small intestine. Conclusions Modified Kugel applied in tension-free herniorrhaphy will contribute to enhance repair in ＂entire inguinal region＂, and will be a safe and effective method with rapid recovery after operations.