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腹膜前修补术(开放后路入路)用于既往接受过利希滕斯坦无张力疝修补术治疗的复发性腹股沟疝。

Preperitoneal repair (open posterior approach) for recurrent inguinal hernias previously treated with Lichtenstein tension-free hernioplasty.

作者信息

Karatepe O, Acet E, Altiok M, Adas G, Cak R A, Karahan S

机构信息

Department of Surgery, Okmeydani Education and Research Hospital, Istanbul, Turkey.

出版信息

Hippokratia. 2010 Apr;14(2):119-21.

Abstract

BACKGROUND

The repair of recurrent inguinal hernias after prosthetic mesh repair is usually diffucult due to considerable technical challenge and complications. There is also a greater risk of developing further recurrence. The aim of this study was to investigate the outcome of preperitoneal repair (open posterior approach) for recurrent inguinal hernias after Lichtenstein tension-free hernioplasty.

METHODS

We performed a prospective clinical study in 44 patients having recurrent inguinal hernias the period 2002- 2008. Preperitoneal repair was performed on all patients who have had Lichtenstein tension-free hernioplasty previously. The age, gender, operating time, hospital stay, postoperative complication rates and recurrence rates of patients were evaluated.

RESULTS

There were no serious intraoperative complications. There were 36 men and 9 women in the study, whose average age was 38.45 (25-68) years. The average operative time and hospital stay were 44.56 (30-120) min and 1.6 (1-3) days, respectively. Complications included 4.5 % seromas, 4.5 % hematomas and urinary retention in 9.09 % patients. Follow-up to date is 1-90 months (range, median 40 months).

CONCLUSIONS

We concluded that the preperitoneal repair (open posterior approach) in recurrent inguinal hernias after Lichtenstein tension-free hernioplasty is a safe and efficient method with low complication and rerecurrence rates.

摘要

背景

人工合成补片修补术后复发性腹股沟疝的修复通常具有很大的技术挑战和并发症,因而难度较大。进一步复发的风险也更高。本研究的目的是探讨在Lichtenstein无张力疝修补术后采用腹膜前修补术(开放后路入路)治疗复发性腹股沟疝的疗效。

方法

我们对2002年至2008年期间44例复发性腹股沟疝患者进行了一项前瞻性临床研究。对所有先前接受过Lichtenstein无张力疝修补术的患者进行腹膜前修补术。评估患者的年龄、性别、手术时间、住院时间、术后并发症发生率和复发率。

结果

术中无严重并发症。研究中有36名男性和9名女性,平均年龄为38.45岁(25 - 68岁)。平均手术时间和住院时间分别为44.56分钟(30 - 120分钟)和1.6天(1 - 3天)。并发症包括4.5%的血清肿、4.5%的血肿以及9.09%的患者出现尿潴留。随访时间为1至90个月(范围,中位数40个月)。

结论

我们得出结论,Lichtenstein无张力疝修补术后复发性腹股沟疝采用腹膜前修补术(开放后路入路)是一种安全有效的方法,并发症和再次复发率较低。

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