腹外疝的治疗现状及进展

Status and advancement of treatment of external abdominal hernia

腹外疝是腹腔内的脏器或组织连同壁层腹膜,经过先天的或后天的腹壁薄弱点、孔隙向体表突出而形成的。是外科常见的疾病之一,其中腹股沟疝约占腹外疝发病率的90%~95%。而疝修补术又是外科最为常见和最基本的手术。环顾历史,腹股沟疝的治疗方法经历了一个漫长的发展过程。从16世纪起,现代解剖概念的引入,疝的手术开始遵循解剖关系进行,经过外科医生的不断努力,直到20世纪初,才真正建立起了现代腹股沟疝的外科手术模式。自1884年巴西尼创建真正的解剖疝修补以来,经过医生们的不断地努力补充,才有了从有张力疝修补到无张力疝修补进而发展到腹腔镜疝修补术。各种术式及治疗方法均有其各自的优缺点,进而要求在治疗中,统一标准,规范手术,根据疝分型选择恰当的修补方式,熟练操作,精通解剖,避免过度治疗,减少不必要的损伤,以达到最佳的疗效。

External abdomindl hernia is formed by introperitoeal organs or tissues and the parietal peritoneum in the abdominal cavity swell to the surface through the abdominal wall. This is one of the common diseases of surgery. Among these inguinal hernia＇s incidence accounts for about 90% ~95%.Hernia repair surgery is the most common and fundamental operation. In history, the treatment of inguinal hernia has experienced a long process of development. From sixteenth Century, with the introduction of the concept of modern anatomy, the operation of the hernia began to the follow the anatomical structure. And through the continuous efforts of the surgeon, until the beginning of the twentieth Century, the modern surgical operation mode of the inguinal hernia was established. Since 1884 Bassini Nepal created a real anatomical hernia repair, through doctor＇s efforts gradually established the tension hernia repair and the tension free hernia repair operation and developed to the laparoscopic hernia repair operation. All kinds of operation and treatment methods had their own advantages and disadvantages, So we have to avoid excessive treatment, follow the standard operation, and choose the proper operation according to the type of hernia. At the same time we need to operate skilled, master anatomy, reduce unnecessary damage, get the best efficacy.