Dabić D, Cerović S, Azanjaç B, Marić B, Kostić I
Department of Surgery, General Hospital Cacak, Serbia.
Acta Chir Iugosl. 2010;57(2):49-54. doi: 10.2298/aci1002049d.
The employment of a diversity of prosthetic materials and several types of mesh different in construction is opening a new chapter in hernia surgery and tension-free techniques are becoming a "golden standard" for repairing abdominal wall defects, whereas the conventional methods, i.e., the tension techniques are performed on young patients having small direct, indirect, or femoral hernias.
The aim of this retrospective study is to present the results of using Prolene Hernia System (PHS), Ultrapro Hernia System (UHS) and 3D Patch (3DP) devices in the treatment of inguinal, femoral, umbilical and small incisional hernias in outpatient surgery.
From January 2006 to January 2009, 70 patients were operated on for abdominal wall hernias (54 inguinal, 4 femoral, 8 umbilical and 4 small incisional hernias) using PHS, UHS and 3DP devices. All the patients underwent surgery under local infiltrative anaesthesia. All the surgical operations were performed by a single surgeon, 19 of them in the General Hospital and 51 in a private polyclinic.
The mean size of the hernia defect in the inguinal, femoral and umbilical hernias was 2.5 cm (1-4 cm), while in the incisional hernias it was 4.5 cm (3-6 cm). The mean operating time was 2.4 hrs (2-6 hrs). There were no requirement for urinary drains. The mean follow-up was 18 months (0-36 months). The incidence of infection, chronic pain and recurrence was 0%. Three of the patients had complications: seroma in one patient with an incisional hernia and hematoma in two patients after inguinal hernia repair.
The employment of PHS, UHS and 3DP devices, which have not yet been widely accepted in our hospitals, has had outstanding results in outpatient surgery. In addition, the type of anaesthesia and the 3D mesh construction prepare the way for a short hospital stay, smooth recovery and a swift return to normal activity.
多种修复材料的应用以及几种结构不同的补片开启了疝外科的新篇章,无张力技术正成为修复腹壁缺损的“金标准”,而传统方法,即张力技术则用于患有小型直疝、斜疝或股疝的年轻患者。
这项回顾性研究的目的是展示使用普理灵疝修补系统(PHS)、超普疝修补系统(UHS)和3D补片(3DP)装置在门诊手术中治疗腹股沟疝、股疝、脐疝和小切口疝的结果。
2006年1月至2009年1月,70例腹壁疝患者(54例腹股沟疝、4例股疝、8例脐疝和4例小切口疝)接受了使用PHS、UHS和3DP装置的手术。所有患者均在局部浸润麻醉下接受手术。所有手术均由一名外科医生完成,其中19例在综合医院进行,51例在私立诊所进行。
腹股沟疝、股疝和脐疝的疝缺损平均大小为2.5厘米(1 - 4厘米),而切口疝的疝缺损平均大小为4.5厘米(3 - 6厘米)。平均手术时间为2.4小时(2 - 6小时)。无需留置尿管。平均随访时间为18个月(0 - 36个月)。感染、慢性疼痛和复发的发生率为0%。3例患者出现并发症:1例切口疝患者出现血清肿,2例腹股沟疝修补术后患者出现血肿。
PHS、UHS和3DP装置在我们医院尚未被广泛接受,但在门诊手术中取得了出色的效果。此外,麻醉方式和3D补片结构为缩短住院时间、顺利康复以及迅速恢复正常活动创造了条件。