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局部麻醉下进行改良库格尔疝修补术的早期经验。

Early experience of performing a modified Kugel hernia repair with local anesthesia.

作者信息

Li Junsheng, Zhang Yanan, Hu Haolin, Tang Whenhao

机构信息

Department of General Surgery, Affiliated Zhong-Da Hospital, Southeast University, Nanjing, Jiangsu Province, PR China.

出版信息

Surg Today. 2008;38(7):603-8. doi: 10.1007/s00595-007-3681-7. Epub 2008 Jul 9.

Abstract

PURPOSE

We report our results with the modified Kugel hernia repair, a relatively new and minimally invasive open technique offering the advantages of preperitoneal repair without the need for general anesthesia.

METHODS

We performed 42 inguinal or femoral hernias (44 sides), including incarcerated femoral hernias, using this modified technique, giving the patient local anesthesia with very little sedation. We describe the operative techniques used and the postoperative complications encountered.

RESULTS

The mean operation time was 55 +/- 26 min and the mean hospital stay was 4 days (2-8 days). There were no major postoperative complications and patients were followed up for a mean period of 1 year. Only one patient complained of mild discomfort in the inguinal area after 6 months. There was no incidence of recurrence.

CONCLUSION

The modified Kugel hernia repair is easy to learn, and it seems to have a lower recurrence rate and fewer postoperative complications than conventional types of hernia repair. Moreover, it offers the advantage of allowing the patient to undergo preperitoneal inguinal hernia repair under local anesthesia, which is especially beneficial for older patients with preoperative morbidity.

摘要

目的

我们报告改良Kugel疝修补术的结果,这是一种相对较新的微创开放技术,具有腹膜前修补的优点且无需全身麻醉。

方法

我们使用这种改良技术对42例腹股沟疝或股疝(44侧)进行了手术,包括嵌顿性股疝,仅给予患者少量镇静的局部麻醉。我们描述了所使用的手术技术以及遇到的术后并发症。

结果

平均手术时间为55±26分钟,平均住院时间为4天(2 - 8天)。无重大术后并发症,患者平均随访1年。仅1例患者在6个月后诉腹股沟区轻度不适。无复发情况。

结论

改良Kugel疝修补术易于学习,与传统疝修补术相比,其复发率似乎更低,术后并发症更少。此外,它具有让患者在局部麻醉下进行腹膜前腹股沟疝修补的优势,这对术前有合并症的老年患者尤为有益。

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