Goswami Rup, Babor Mohammed, Ojo Akinyede
Department of General Surgery, King George Hospital, Ilford, United Kingdom.
J Laparoendosc Adv Surg Tech A. 2007 Oct;17(5):669-72. doi: 10.1089/lap.2006.0135.
Repair of inguinal hernia is the most commonly performed surgical procedure. Both open and laparoscopic methods are accepted modalities of surgical treatment. Transabdominal preperitoneal (TAPP) and total extraperitoneal (TEP) are the two types of laparoscopic repair of the inguineal hernia. The main advantages of laparoscopic repair, as compared to open repair, are a shorter hospital stay and a quicker recovery to normal activities. However, laparoscopic repairs are associated with a higher incidence of visceral and vascular injuries. One particular complication is the migration and erosion of mesh into the adjacent viscera. Although the total numbers of cases are small, compared to the total numbers of inguinal hernia repairs, they are important, as they often presented with a diagnostic dilemma. Most of the mesh migrations reported in the literature involves the urinary bladder. In this paper, we present a case of erosion of mesh into the caecum. The patient (a 66-year-old male) underwent TAPP repair of a right inguinal hernia in 1996 with polypropelene mesh. He also underwent an open appendicectomy in 1980. During the laparoscopic repair, he was found to have multiple intra-abdominal adhesions. He presented with intermittent diarrhea, for which he was investigated, and a benign caecal lesion was found. He was initially managed conservatively. However, his symptoms persisted and he underwent a right hemicolectomy in February 2006 in our hospital. The offending lesion was found to be the prolene mesh having eroded into the caecum.
腹股沟疝修补术是最常施行的外科手术。开放手术和腹腔镜手术方法都是被认可的外科治疗方式。经腹腹膜前修补术（TAPP）和完全腹膜外修补术（TEP）是腹股沟疝的两种腹腔镜修补术式。与开放修补术相比，腹腔镜修补术的主要优点是住院时间较短且能更快恢复正常活动。然而，腹腔镜修补术与内脏和血管损伤的发生率较高相关。一种特殊的并发症是补片向邻近内脏的移位和侵蚀。尽管与腹股沟疝修补术的总数相比，病例总数较少，但它们很重要，因为常常会带来诊断难题。文献报道的大多数补片移位涉及膀胱。在本文中，我们报告一例补片侵蚀盲肠的病例。该患者（一名66岁男性）于1996年用聚丙烯补片进行了右侧腹股沟疝的TAPP修补术。他还在1980年接受过一次开放性阑尾切除术。在腹腔镜修补术中，发现他有多处腹腔内粘连。他出现间歇性腹泻，为此接受了检查，发现有一个良性盲肠病变。他最初接受保守治疗。然而，他的症状持续存在，于2006年2月在我院接受了右半结肠切除术。发现致病病变是已侵蚀入盲肠的普理灵补片。
