前入路腹膜前间隙超普疝装置治疗成人腹股沟疝的临床研究

Anterior preperitoneal inguinal hernia repair with ultrapro hernia system in adult

目的探讨经前入路应用超普疝装置（UHS）行腹膜前间隙无张力成人腹股沟疝修补的手术操作要点,并评价其疗效。方法回顾性分析攀枝花学院附属医院2011年4月至2014年5月,应用UHS行开放式前入路腹膜前间隙无张力疝修补术,治疗成人腹股沟疝320例的临床资料。结果 320例患者全部治愈,手术时间38～90 min,平均53 min。随访290例（90.6%）,随访时间6～36个月,平均18个月。术后腹股沟区有慢性疼痛9例（较严重3例）,阴囊水肿15例,脂肪液化6例,皮下淤血5例,复发1例,感染1例,无睾丸萎缩、睾丸坏死、肠瘘等并发症发生。结论前入路应用轻量型部分可吸收UHS腹膜前间隙无张力疝修补术治疗成人腹股沟疝安全有效,术后恢复快,疗效满意。补片能完全覆盖耻骨肌孔,增强腹横筋膜前后壁,应用UHS腹膜前间隙无张力疝修补术是目前治疗成人腹股沟疝较理想的方法。

ObjectiveTo evaluate the key point and efficacy of anterior preperitoneal tension-free herniorrhaphy with UltraPro Hernia System （UHS） for adult inguinal hernia.MethodsUHS had been used in 320 adult cases from April 2011 to May 2014 in the Affiliated Hospital to Panzhihua College, and their clinical data were retrospectively reviewed.ResultsAll 320 patients had cured. The operative time was 38 to 90 minutes, with an average of 55 minutes. There were 290 cases （90.6%） had been followed up for 6 to 36 months, with an average of 18 months. Chronic postoperative groin pain occurred in 9 patients （3 cases with serious pain）, scrotal oedema in 15 cases, fat necrosis in 6 cases, subcutaneous congestion in 5 cases, recurrence in 1 case and infection in 1 case. However, there were no other complications such as testicular atrophy, testicular necrosis and intestinal fistula.Conclusion The anterior preperitoneal tension-free herniorrhaphy repair with UHS （light weight, partial absorbable mesh） is safe and effective with rapid recovery for inguinal hernia in adult. The mesh can completely cover myopectineal orifice, enhance anterior and posterior wall of transverse fascia. It is the optimal way for the treatment of adult inguinal hernia.