Comparative Analysis of the Efficacy of Transabdominal Pre-Peritoneal Vs Open Tension-Free Hernia Repair in Treating Inguinal Hernia

Objective:To investigate and analyze the clinical outcomes of inguinal hernia patients treated with transabdominal pre-peritoneal repair(TAPP)versus open tension-free hernia repair.Methods:The study was carried out from January 2021 to August 2023,and a total of 50 inguinal hernia patients were selected for this study.The patients were randomly divided into a study group(n=25)and a control group(n=25)by the numerical table method.The patients in the control group were treated with open tension-free hernia repair,whereas the patients in the study group were treated with TAPP.The surgical and postoperative recovery indexes,complication rates,and recurrence rates of the two groups were compared.Results:There was no significant difference in the operative time and intraoperative blood loss between the two groups(P>0.05),and the postoperative feeding time,time out of bed,and hospitalization time of the study group were shorter than those of the control group(P<0.05);the incidence rate of postoperative complications in the study group was lower than that in the control group(P<0.05);and there was no significant difference in the recurrence rate of the two groups after operation(P>0.05).Conclusion:Compared to open tension-free hernia repair,TAPP offers a shorter postoperative recovery duration and hospitalization time,and reduces the incidence of complications.Therefore,this surgical method should be popularized in the treatment of inguinal hernia.

Analysis of Ultrasound-guided Ilioinguinal and Iliohypogastric Nerve Block in Tension-Free Inguinal Hernia Repair in Elderly Patients

Objective:To explore the value of ultrasound-guided ilioinguinal and iliohypogastric nerve block(IINB)in tension-free inguinal hernia repair in elderly patients.Methods:A total of 70 elderly patients with tension-free inguinal hernia repair who treated in the hospital from April 2018 to November 2019 were selected and divided into two groups according to the random number table method,with 35 cases each.The control group underwent infiltration of local anesthesia(LA),and the study group added with IINB.The visual analogue scale(VAS)scores of the two groups of patients were compared.Results:The VAS score of the study group when pulling the hernia sac was lower than that of the control group,and the difference was statistically significant(P<0.05).Conclusion:IINB has good analgesic effect in tensionfree inguinal hernia repair in elderly patients,and it is worth promoting.

Analysis of the Effect and Efficiency of Tension- Free Hernia Repair and Traditional Surgery in The Treatment of Hernia

Objective: To analyze the efficiency of tension-free hernia repair and traditional surgery in the treatment of hernia. Methods: A total of 80 patients with hernias were selected and randomly into a control group (traditional hernia repair) and an observation group (tension-free hernia repair), of 40 cases each. The perioperative indicators, pain, physiological stress indicators, complications, and recurrence rates between the two groups were compared. Results: The perioperative indexes of the observation group were better than those of the control group (P < 0.05). The postoperative pain score, postoperative physiological stress index level, incidence of complications, and recurrence rate of the observation group were lower than those of the control group (P < 0.05). Conclusion: In the surgical treatment of hernia, tension-free hernia repair was less traumatic and had a better effect than traditional hernia repair.

Analysis of the Causes of Chronic Pain after Inguinal Hernia Repair without Tension and Its Prevention and Treatment

Purpose: Analyzing the causes of pain after tension-free repair in the inguinal hernia, and propose corresponding treatment strategies. Results: The patients in this group were followed up for 3 - 12 months. A total of 5 patients still had pain relief within 3 months after surgery. Further treatment was needed, and the incidence rate was 5%. Conclusion: Skilled surgical procedures are performed in patients with local anesthesia, and some of the absorbable repair materials can be used. The improved patch fixation and extra peritoneal repair can reduce the pain after inguinal hernia repair without tension.

Intestinal erosion caused by meshoma displacement:A case report

BACKGROUND A meshoma formation and erosion to the small intestine is rare.Herein,we report one case of a meshoma that was not treated early;causing it to displace and erode the small intestine,with infection,complete control of symptoms was achieved after removal of the infected patch mass,no recurrence of hernia after 2 years of follow-up.CASE SUMMARY A 62-year-old male patient presented with recurrent abdominal pain repeatedly for 1 wk,which has worsened 2 d before admition,accompanied by fever.Five years before presentation he underwent right inguinal hernia Plug and patch repair approach.Two years ago,a computed tomography scan revealed a right lower abdominal mass with soft tissue density,measuring approximately 30 mm×17 mm,which was diagnosed as meshoma that was not treated.The patient had poorly controlled diabetes in the past year.CONCLUSION The formation of meshoma is rare,and that if not treated in time it might erode and require resection of the involved organ.

不同年龄段腹股沟斜疝行无张力疝修补的临床对照研究

目的探讨疝环充填式无张力疝修补术对不同年龄腹股沟斜疝的治疗效果。方法将190例腹股沟斜疝患者根据年龄分成两组:60岁以上和60岁以下组,比较每组手术效果及并发症。结果在60岁以上组,疝环充填式无张力斜疝修补术在手术时间、平均下床活动时间、疼痛、牵拉不适以及复发等并发症方面优于传统腹股沟斜疝修补术;而在60岁对以下组,并不优于传统腹股沟斜疝修补术。结论疝的治疗应根据个体化原则进行。

传统疝修补术与平片无张力疝修补术治疗腹股沟疝的对比性临床研究

目的:观察分析传统疝修补术与平片无张力疝修补术治疗腹股沟疝的临床疗效。方法:选取本院2013年9月-2015年9月收治的318例腹股沟疝患者作为研究对象,采用随机数表法将所有患者均分为两组,即对照组和观察组,每组159例。对照组患者给予传统疝修补术进行治疗,观察组患者给予平片无张力疝修补术进行治疗,比较两组患者的临床治疗总有效率、术中情况(术中出血量、出血率、切口长度、手术时间)、术后情况(疼痛评分、疼痛率、术后恢复时间、住院时间、住院经费)、并发症发生状况(异物感、阴囊水肿、切口感染、发热、神经性疼痛)及复发率。结果:对照组和观察组临床治疗总有效率分别为73.58%(117/159)和94.34%(150/159),比较差异有统计学意义(P<0.05);观察组患者术中出血量、出血率、切口长度、手术时间、疼痛评分、疼痛率、术后恢复时间、住院时间、住院经费均显著优于对照组,比较差异均有统计学意义(P<0.05);术后随访中观察组患者异物感、阴囊水肿、切口感染、发热、神经性疼痛发生率和复发率均显著低于对照组,比较差异均有统计学意义(P<0.05)。结论:平片无张力疝修补术治疗腹股沟疝的临床疗效显著,可显著降低复发率和并发症发生率,具有临床应用价值,可在临床上推广。

局麻下无张力疝修补术在老年性腹股沟疝治疗中的应用体会

目的探讨局麻下无张力疝修补术治疗老年性腹股沟疝的临床疗效。方法将94例老年性腹股沟疝患者采用随机数字表法分为对照组(n=47)和观察组(n=47),对照组在连续硬膜外阻滞麻醉下行无张力疝修补术治疗,观察组采用局麻下无张力疝修补术治疗。结果观察组术后下床活动时间、住院时间、住院费用及术后并发症发生率均优于对照组(P<0.05);两组患者手术时间、术中出血量及术后镇痛药物使用率比较,差异无统计学意义(P>0.05))。结论局麻下无张力疝修补术治疗腹股沟疝操作简单、经济实用、术后近期并发症少,更加适用于老年患者。

无张力疝修补术的临床分析

目的探讨无张力疝修补术在治疗疝中的临床应用价值。方法采用美国美外公司的疝环充填物及网状补片行无张力疝修补术治疗腹外疝100例。结果全组病例切口均Ⅰ期愈合,术后3～7 d出院,随访至今无复发。结论无张力疝修补术是一种快捷、无痛、复发率低的手术方法。

局部浸润麻醉下无张力疝修补术在老年腹股沟疝中的应用

目的:为合并多种疾病的老年腹股沟疝患者寻找一种合适的麻醉手术方法。方法:对采用人工合成材料行腹股沟无张力疝修补手术23例,分析临床资料。结果:手术时间平均45min。无切口感染,无尿潴留,阴囊积液。随访12～36个月,平均24个月,均无复发。结论:局部神经阻滞麻醉下的腹股沟无张力疝修补术是一种安全、可靠、简便、经济的方式。

UHS与Lichtenstein无张力疝修补术的对比研究

目的比较腹股沟疝应用UHS装置与Lichtenstein修补术式的优缺点。方法回顾性分析2010-12—2012-12间行UHS疝修补114例与Lichtenstein疝修补88例手术时间、术后住院天数、慢性疼痛、并发症等资料。结果 2种术式在住院时间、复发率等方面差异无统计学意义(P>0.05);Lichtenstein修补术手术时间明显短,手术费用低,但术后慢性疼痛评分较高。结论应用UHS装置与Lichtenstein无张力疝修补术均可以用于腹股沟疝修补,各有优缺点。

经腹治疗先天性膈疝临床体会

报告5例隔疝的诊治体会。认为本病常有误诊，术前须与隔肌膨出鉴别，因两者手术方式不同。确诊后应及早手术，以降低死亡率。采用经腹隔疝修补术可以同时矫治肠道旋转不良。术后常规流置胸腔闭式引流，对患侧肺的膨胀及胸腔内渗液的排出有积极的意义。

成人绞窄性腹股沟斜疝52例临床分析

目的总结外科治疗成人绞窄性腹股沟斜疝的经验。方法回顾性分析1986年1月～2004年12月52例成人绞窄性腹股沟斜疝外科手术的临床资料。结果本组无手术死亡。一期疝修补占92．3％（48／52），其中回肠切除吻合后作疝修补占一期疝修补的66．7％（32／48），术后残留疝囊积液2例，深部切口感染致手术失败后疝复发1例，二期疝修补困难转上级医院行无张力疝修补术治愈。单纯疝囊高位结扎4例（经腹2例，经腹股沟1例，经腹股沟加作腹部切口1例）。结论正确掌握一期疝修补术是治疗成人绞窄性腹股沟斜疝的主要有效方法。

腹腔镜完全腹膜外疝修补术与疝环填充式无张力疝修补术治疗腹股沟疝疗效比较

目的比较腹腔镜完全腹膜外疝修补术与疝环填充式无张力疝修补术治疗腹股沟疝的临床疗效,以期为临床上腹股沟疝治疗方法的选择提供依据。方法选择佛山市顺德区第二人民医院外三科于2015年1月至2017年6月期间收治的102例腹股沟疝患者为研究对象,根据随机数表法分为对照组和观察组,每组51例,对照组采用疝环填充式无张力疝修补术治疗,观察组采用腹腔镜完全腹膜外疝修补术治疗,比较两组患者的手术时间、术中出血量、术后12 h疼痛程度[视觉模拟疼痛评估(VAS)法]等临床指标;术后随访6个月,比较两组患者的复发情况。结果观察组患者的手术时间为(76.5±12.7)min,明显长于对照组的(61.8±9.5)min,但是术中出血量、术后VAS评分、术后下床时间及术后住院时间分别为(10.9±4.4)m L、(2.0±0.8)分、(1.9±0.8)d、(4.9±1.5)d,明显少于对照组的(24.7±7.2)m L、(3.7±1.2)分、(2.8±1.4)d、(7.2±2.5)d,差异均有统计学意义(P<0.05);观察组患者并发症发生率为5.88%,与对照组的9.80%比较差异无统计学意义(P>0.05);两组患者随访期间均无复发病例。结论腹腔镜完全腹膜外疝修补术与疝环填充式无张力疝修补术治疗腹股沟疝均能取得较好的临床效果,前者微创的优势更加明显。

儿童腹股沟斜疝外科治疗进展

儿童腹股沟斜疝是一种最常见的腹外疝。它的发生主要是由先天性解剖异常和后天性腹壁薄弱或缺损等因素作用产生的。随着科技进步和发展,人们对儿童腹股沟斜疝的外科治疗有了更加深入的认识和研究。文章对儿童腹股沟斜疝的多种外科治疗手段加以阐述,从而对该病的临床治疗提供更多合理的新思路。

Comparing the effects of Bassini versus tension-freehernioplasty: 3 years’ follow-up

In order to compare the effects of Bassini and tension-free mesh hernioplasty,a total of 552 patients with inguinal hernia who were subjected to surgical treatment in our hospital were randomly divided into the following two groups:the Bassini group(n=269)and the tension-free mesh group(n=283).The recurrence rates,pain,dis-comfort,and other complications were recorded,and the causes of the complications were explored.The recurrence rate in the Bassini group was 8.9%(24/269),significantly higher than that in the tension-free repair group(2.8%,8/283).In addition,the recurrence rates in the Bassini and tension-free groups before 2004 were 12.6%and 5.6%,respectively,which were markedly higher than the rates after 2004(5.3%and 0.7%,respectively).The rate of post-operative discomfort and pain within thefirst three months was higher in the Bassini group compared to the tension-free group(25.7%vs 18.5%,respectively).However,there was no difference after three months in the rate of post-operative discomfort and pain,incidence of infection,or scrotal edema between the two groups.The average hospital stay in the Bassini group was longer than that in the tension-free repair group(7.6�1.2 vs 4.5�2.2 days,respectively),but the cost was lower(4518.0�510 vs 6221.3�578 yuan,respectively).Thus,tension-free mesh hernioplasty is indicated for most inguinal hernia patients due to the low recurrence rate,rapid recovery time,and treatment success,but the traditional Bassini procedure has lower cost and other beneficial effects and is still suitable for some patients.

开放性无张力和腹腔镜疝修补术的临床对比研究

目的:分析比较开放性无张力和腹腔镜疝修补术的有效性、安全性,为临床手术方式的选择提供参考依据。方法:收集腹股沟疝手术186例,其中开放性无张力疝修补99例,腹腔镜疝修补87例。分析不同手术方式的手术时间、术后平均住院日期、恢复正常工作的时间、并发症、复发率、手术费用等指标的差异。结果:与开放性无张力疝修补术相比腹腔镜疝修补术的术后住院时间以及恢复正常工作的时间较短(P<0.05);但院费用较高(P<0.05)。两组手术方式手术时间,并发症和复发率差异无统计学意义。结论:腹腔镜疝修补术手术效果好、术后恢复快,值得在经济基础好的基层医院广泛开展。

腹膜前间隙修补术治疗成人脐疝15例回顾性分析

目的回顾分析并探讨腹膜前疝修补术治疗成人脐疝的应用价值。方法分析15例腹膜前修补成人脐疝的病例,观察手术时间、住院时间、术后并发症及复发情况。结果手术时间45～80min,平均60min,术后6～8h下床活动,术后切口疼痛较明显3例,术后切口皮下积液1例,平均住院时间5.8d,术后平均随访21个月无复发,无明显异物感。结论腹膜前间隙修补术是治疗成人脐疝的一种有效而可靠的术式,具有手术操作安全,手术适应症广,术后恢复快,并发症少,复发率低等优点。

不同术式疝修补术对成人腹股沟疝临床治疗效果的影响及复发率研究

目的分析对成人腹股沟疝采用不同术式疝修补术的治疗效果,并探讨其复发率。方法将103例成人腹股沟疝患者按随机数字表法分为对照组和观察组,对照组51例行开放式无张力疝修补术,观察组52例行腹腔镜疝修补术。手术完成后比较2组临床疗效、手术时间、术中出血量,随访1个月后比较2组复发率、并发症发生率。结果观察组的临床治疗总有效率为96.1%,明显高于对照组的74.5%(P<0.05);观察组的术中出血量明显较对照组低,且1个月后复发率为0,明显低于对照组的7.8%(P<0.05);2组手术时间无显著差异(P>0.05);观察组的并发症发生率为5.8%,对照组为11.8%,观察组略低于对照组,但2组比较无显著差异(P>0.05)。结论对成人腹股沟疝患者行腹腔镜疝修补术,具有更显著的疗效,且复发率、术中出血量也较开放式无张力疝修补术更低。

腹腔镜全腹膜外疝修补术与经腹腹膜前修补术治疗老年腹股沟疝的疗效比较

目的比较腹腔镜全腹膜外疝修复术(TEP)与经腹腹膜前修补术(TAPP)治疗老年腹股沟疝的疗效.方法94例老年腹股沟疝患者按随机数字表法分为TEP组与TAPP组,每组各47例,分别行TEP和TAPP治疗.比较两组围术期情况、术后并发症发生及复发情况,分别于术前、术后1d、3d和7d测定血清应激指标[C反应蛋白(CRP)、皮质醇(Cor)、β-内啡肽(β-EP)]水平,于术后1d、3d、7d、3个月和12个月采用简版McGill疼痛问卷(SF-MPQ)评价术后疼痛,统计慢性疼痛等并发症发生率及疝复发率.结果两组手术时间、术中出血量、住院时间比较,差异均无统计学意义(P>0.05),但TEP组术后首次下地活动时间及胃肠功能康复时间均短于TAPP组(P<0.05).术后1d、3d、7d,TEP组血清CRP、Cor、β-EP及SF-MPQ评分均低于TAPP组(P<0.05),术后3、12个月时两组SF-MPQ评分比较差异无统计学意义(P>0.05).TEP组慢性疼痛发生率为2.13%,与TAPP组10.64%比较差异无统计学意义(P>0.05).两组总并发症发生率、1年复发率比较,差异无统计学意义(P>0.05).结论TEP和TAPP治疗老年腹股沟疝安全可行,TEP可能短期内疼痛应激更轻,但TAPP手术难度相对较低,两种术式的疗效、慢性疼痛及复发率相当.