疝环充填式无张力疝修补术在滑疝治疗中的应用

Application of mesh plug tension-free hernioplasty in sliding hernia

目的分析滑疝的特点和评价疝环充填式无张力疝修补术在滑疝治疗中的疗效。方法回顾性分析我院1999年1月至2001年12月收治并行疝环充填式无张力疝修补术的16例滑疝的临床资料。结果16例滑疝患者中,斜疝15例(其中2例为复发疝),直疝1例。均采用疝环充填式无张力疝修补法,疝环大小为2.5～5.0cm,其中5例为5.0cm。疝内容物右侧多为盲肠、膀胱,左侧多为乙状结肠、膀胱。16例中,除2例术后有轻度皮下积血、1例偏头痛外,其余13例无术后并发症发生,均在术后4～5d出院。随访5～40个月,无1例术后复发。结论疝环充填式无张力疝修补术应用于滑疝的治疗有一定的优势;滑疝手术中应熟悉解剖层次,避免不必要的损伤,以减少术后复发。

Objective To analyze the characteristics of sliding hernia and evaluate the therapeutic effect of mesh plug tension free hernioplasty on sliding hernia. Methods Sixteen cases with sliding hernia underwent mesh plug tension free hernioplasty from January 1999 to December 2001, and their clinical data were analyzed retrospectively. Results Among 16 sliding hernias, 15 were inguinal oblique hernias, one was direct hernia. The diameters of hernia loop ranged from 2 5cm to 5 cm. Caecum and bladder were the main saccular contents of hernia in the right, while sigmoid colon or bladder in the left. Postoperative complications included hypoincisional haematoma in 2 cases and splitting headache in one case. All patients were discharged at the forth or fifth postoperative day. After 5～40 months follow up, no recurrence was found. Conclusions Mesh plug tension free hernioplasty for sliding hernia has the advantages of simple performance, less trauma, better therapeutic effect, and low recurrence rate. Familiarity with the anatomy of the hernia is needed to avoid injury and reduce recurrence.