生物补片在青少年腹股沟疝的应用

Application of biological mesh in treatment of inguinal hernia in adolescents

青少年(一般认为13~18岁)腹股沟疝的发病原因多为先天性鞘状突未闭,亦有腹横筋膜缺损、疝囊较大的情况,单纯疝囊高位结扎复发率高。考虑到青少年处于发育阶段,合成补片无法随青少年成长而伸展,补片挛缩可能造成术后局部产生牵拉、异物感,发生慢性疼痛,甚至可引起精索黏连,影响生育,不建议用于青少年。而生物补片刺激机体组织再生修复缺损的同时,自身可被降解,术后局部不适和慢性疼痛发生率较低,因此比较适合应用于青少年腹股沟疝修补,但是对于其复发问题目前尚无结论,仍需大样本多中心的临床研究来证实远期效果。

The causes of inguinal hernia in adolescents(generally believed to be 13 to 18 years old)are mostly congenital patent processus vaginalis,as well as transverse fascia defect and large hernial sac.Traditional high ligation of the hernia sac is prone to postoperative recurrence.Considering that adolescents are at the stage of development,synthetic materials do not enlarge with the children's growth,and complications,such as local contracture,foreign body sensation,chronic pain,even adhesions of the spermatic cord and infertility in adolescents can occur.Therefore,they are not recommended for use in adolescents.While biological mesh can stimulate regeneration of new tissues to repair defects,at the same time,it will gradually degrade with low incidence of postoperative local discomfort and chronic pain.The aforementioned features of biological mesh make it very suitable for the repair of inguinal hernias in adolescents.But there is no conclusion about its recurrence at present.Thus,we expect a large sample,multi-center clinical study to further demonstrate the long-term efficacy of biological meshes.