Subhas Gokulakkrishna, Bakston Daniel, Gupta Aditya, Jacobs Michael J, Mittal Vijay K, Silapaswan Sumet
Department of Surgery, Providence Hospital and Medical Centers, Southfield, Michigan 48075, USA.
Am Surg. 2010 Sep;76(9):933-7.
Tension-free, open-mesh, inguinal herniorrhaphies have gained wide acceptance. Current mesh techniques reinforcing the internal ring do not provide a comfortable lay to the mesh. To address this, we used the internal ring occlusion and floor support (IROFS) technique. A retrospective review was undertaken of all hernias operated on with the IROFS technique from January 2001 to December 2006. Five hundred twenty-five inguinal hernia repairs were done in 477 male patients. Telephone questionnaires looking into their postoperative course and recurrence were recorded. We contacted 275 (58%) patients. Patients' ages ranged from 29 to 81 years (mean, 57 years). The hernia was indirect in 50 per cent (n=146), direct in 35 per cent (n=102), or both in 15 per cent (n=44) of patients. The average operative time was 40 minutes. Acute wound pain lasted for less than 1 week in 55 per cent (n=151) and for 1 to 2 weeks in 24 per cent (n=66). Postoperative analgesic requirement was less than 1 week in 54 per cent (n=147) and 1 to 2 weeks in 27 per cent (n=74). Most patients returned to their daily activities in 2 weeks (75%) and to work in 3 weeks (74%). Chronic pain lasted for 6 to 48 months (mean, 20 months) in only seven patients. No recurrence of hernia was observed during follow-up visits (range, 26-96 months; mean, 53 months). In conclusion, IROFS can be performed with little difficulty, is cost-effective, and is well tolerated by the patient.
无张力开放式腹股沟疝修补术已被广泛接受。目前加强内环的补片技术无法使补片放置舒适。为解决这一问题，我们采用了内环封闭和盆底支撑（IROFS）技术。对2001年1月至2006年12月期间采用IROFS技术进行手术的所有疝患者进行了回顾性研究。对477例男性患者进行了525例腹股沟疝修补术。记录了调查其术后病程和复发情况的电话问卷。我们联系了275例（58%）患者。患者年龄在29至81岁之间（平均57岁）。50%（n = 146）的患者为间接疝，35%（n = 102）为直接疝，15%（n = 44）的患者为双侧疝。平均手术时间为40分钟。55%（n = 151）的患者急性伤口疼痛持续不到1周，24%（n = 66）的患者持续1至2周。54%（n = 147）的患者术后镇痛需求持续不到1周，27%（n = 74）的患者持续1至2周。大多数患者在2周内（75%）恢复日常活动，在3周内（74%）恢复工作。仅7例患者慢性疼痛持续6至(48)个月（平均20个月）。随访期间（范围26 - 96个月；平均53个月）未观察到疝复发。总之，IROFS操作难度小，性价比高，患者耐受性良好。
