青年腹股沟疝治疗策略

Surgical management strategy of young inguinal hernia patients

青年腹股沟疝的治疗不仅要考虑手术修补方法的选择、降低复发率和减少手术并发症等,还要注意手术对病人生育功能的影响。对于Ⅰ型或Ⅱ型青年人腹股沟疝采用Bassinni或Shouldice方法修补或无张力修补,Ⅲ型疝或复发疝建议应用补片进行无张力修补,补片最好选用生物补片。Lichtenstein修补术可以选用生物补片或轻量大网孔合成补片。采用腹腔镜完全腹膜外疝修补术(TEP)或经腹腔腹膜前疝修补术(TAPP)治疗青年腹股沟疝时应选用生物补片。较大的疝囊可以横断结扎,避免在游离疝囊过程中损伤精索血管或输精管。

The treatment of young inguinal hernia should not only consider the choice of surgical repair methods, reducing the recurrence rate and the complications of operation, but also pay attention to the influence of the operation on the fertility function of the patients. Bassinni or Shouldice hernia repair method is good choice for tape I or I1 inguinal hernia. Tape II[ or recurrence hernia repair recommends tension-free hernia repair. It is best for all tension-free hernia repair method to choose biological mesh. Lichtenstein repair may choose biological mesh and light large pole mesh. Totally extraperatoneal （TEP） or transabdominal preperatoneal （TAPP） in young patients may also choose biological mesh. Huge hernia sac might be traversed and ligated to avoid injuring the spermatie cord vessels and vas deferens.