Szentkereszty Z, Boros M, Sápy P, Kiss S Sz
2nd Department of Surgery, Medical and Health Science Center, University of Debrecen, Móricz Zs. Krt. 22, 4004 Debrecen, Hungary.
Hernia. 2006 Aug;10(4):354-6. doi: 10.1007/s10029-005-0035-5. Epub 2006 May 31.
The intercostal hernia of the lung is a very rare extraordinary disease that requires operation because of the complaints and potential complications. The authors review cases of their operations and analyze the subsequence and treatment. Three patients have been treated for intercostal lung hernia in our treatment. The causes of this disease were a previous thoracotomy in one case and fits of coughing in the other two cases. The diagnosis was set up on the grounds of the specific clinical symptoms, thoracic X-ray and CT scan. The hernia was dissolved with percostal stitches and with the suture of the thoracic musculature in two cases. Plastic operation of the thoracic wall by implanting a polypropylene surgical mesh (Prolen, Ethicon, Johnson & Johnson) was performed in the case of the third patient and later in the first two patients due to recrudescence. In one case the authors were constrained to resect the dystelectasial lung in the hernial sac. The three patients had been operated five times. Relapse of hernia was detected in two patients, in whom the intercostal space had been reconstructed with percostal stitches. We did not detect any relapsing in those two patients at 33 and 66 months after the second operation with mesh implantation. The third patient who got mesh implant immediately did not relapse 12 months after the operation. Intercostal lung hernia is an indication of operation. A plastic operation of the thoracic wall combined with the implantation of a surgical mesh is recommended to close the hernial orifice, which is suitable for treating both primary and relapsed hernias. Recurrence is rare in those patients treated with this method.
肺肋间疝是一种非常罕见的特殊疾病，因其引发的不适症状和潜在并发症而需要进行手术治疗。作者回顾了他们的手术病例并分析了后续情况及治疗方法。在我们的治疗中，有3例患者接受了肺肋间疝治疗。该疾病的病因，1例是既往有开胸手术史，另外2例是咳嗽发作。诊断依据特定的临床症状、胸部X线和CT扫描确定。2例患者通过肋间缝合和胸壁肌肉缝合来消除疝。第3例患者以及之后因复发而接受治疗的前2例患者，采用植入聚丙烯外科网片（普理灵，爱惜康，强生公司）进行胸壁整形手术。在1例患者中，作者不得不切除疝囊内的肺不张肺组织。这3例患者共接受了5次手术。2例患者出现疝复发，这2例患者此前曾通过肋间缝合重建肋间间隙。在第二次植入网片手术后33个月和66个月，我们未发现这2例患者有任何复发情况。第3例立即植入网片的患者在术后12个月未复发。肺肋间疝是手术指征。建议采用胸壁整形手术并植入外科网片来闭合疝孔，这适用于治疗原发性和复发性疝。采用这种方法治疗的患者复发罕见。
