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腹股沟疝修补三联联合疝修补术:1411例经验

Triple-combined herniorrhaphy for inguinal hernia repair: experience of 1411 cases.

作者信息

Tseng Chen-Chiang, Lin Alpha Dian-Yu

机构信息

Department of Surgery, Taichung Poh-Ai Hospital, Taichung, Taiwan.

出版信息

Hepatogastroenterology. 2007 Jul-Aug;54(77):1433-7.

Abstract

BACKGROUND/AIMS: The optimum method for inguinal hernia repair has not yet been determined. Triple-Combined Herniorrhaphy, using the combined methods of McVay, Shouldice and Halsted repairs, was developed in our hospital over the past years in order to improve the overall results of treatment of inguinal hernia. The aim of this study was to verify the value of this surgical technique for primary inguinal hernia in a specialized hospital setting.

METHODOLOGY

We describe our experience of 1411 consecutive patients for whom Triple-Combined Herniorrhaphy was performed for inguinal hernia repair at our hospital between September 2000 and August 2003, under local anesthesia with a "one-day surgery" regimen.

RESULTS

The type of hernias included 342 direct inguinal hernias, 913 indirect inguinal hernias, and 156 pantaloon (mixed) type inguinal hernias. No mortality or major intraoperative complications were observed. The median duration of operation time was 25 min. Wound infection and hematoma formation requiring drainage was observed in 9 and 16 patients, respectively. Patients had fast convalescence with rapid resumption of working activity. The postoperative recurrence rate was 1.2%.

CONCLUSIONS

Triple-Combined Herniorrhaphy is a simple, safe, comfortable, and effective method with low early and later morbidity and recurrence rate. The good results of this procedure constitute a good alternative to mesh or other open inguinal repairs.

摘要

背景/目的:腹股沟疝修补的最佳方法尚未确定。在过去几年中,我院开发了三联疝修补术,即联合应用麦克维(McVay)、肖尔代斯(Shouldice)和霍尔斯特德(Halsted)修补方法,以提高腹股沟疝治疗的整体效果。本研究的目的是在专科医院环境中验证这种手术技术对原发性腹股沟疝的价值。

方法

我们描述了2000年9月至2003年8月期间在我院连续1411例接受三联疝修补术治疗腹股沟疝患者的经验,手术在局部麻醉下采用“一日手术”方案进行。

结果

疝的类型包括342例腹股沟直疝、913例腹股沟斜疝和156例马鞍型(混合型)腹股沟疝。未观察到死亡或术中重大并发症。手术时间的中位数为25分钟。分别有9例和16例患者出现伤口感染和需要引流的血肿形成。患者恢复快,能迅速恢复工作活动。术后复发率为1.2%。

结论

三联疝修补术是一种简单、安全、舒适且有效的方法,早期和后期发病率及复发率均较低。该手术的良好效果是补片修补或其他开放式腹股沟修补术的良好替代方案。

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