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使用创新的自固定半可吸收补片进行无张力腹股沟疝开放修补术。

Tension free open inguinal hernia repair using an innovative self gripping semi-resorbable mesh.

作者信息

Chastan Philippe

机构信息

Clinique des 4 pavillons, Rue Edouard Herriot, 33310 Lormont, France.

出版信息

J Minim Access Surg. 2006 Sep;2(3):139-43. doi: 10.4103/0972-9941.27726.

Abstract

AIMS

Inguinal hernia repair according to Lichtenstein technique has become the most common procedure performed by general surgeons. Heavy weight polypropylene meshes have been reported to stimulate inflammatory reaction responsible for mesh shrinkage when scar tissue evolved. Additionally, some concerns remain regarding the relationship between chronic pain and mesh fixation technique. In order to reduce those drawbacks, we have developed a new mesh for anterior tension free inguinal hernia repair which exhibits self-gripping absorbable properties.

MATERIALS AND METHODS

52 patients (69 hernias) were prospectivly operated with this mesh (SOFRADIM-France) made of low-weight isoelastic large pores knitted fabric which incorporated resorbable micro hooks that provides self gripping properties to the mesh during the first months post-implantation. The fixation of the mesh onto the tissues is significantly facilitated. The mesh is secured around the cord with a self gripping flap. After complete tissular ingrowth and resorption of the PLA hooks, the low-weight (40 g/m(2)) polypropylene mesh insures the long term wall reinforcement.

RESULTS

Peroperativly, no complication was reported, the mesh was easy to handle and to fix. Discharge was obtained at Day 1. No perioperative complication occurred, return to daily activities was obtained at Day 5.5. At one month, no neurological pain or other complications were described.

CONCLUSIONS

Based on the first results of this clinical study, this unique concept of low density self gripping mesh should allows an efficient treatment of inguinal hernia. It should reduce postoperative complications and the extent of required suture fixation, making the procedure more reproducible.

摘要

目的

按照利希滕斯坦技术进行腹股沟疝修补术已成为普通外科医生最常开展的手术。据报道,重磅聚丙烯补片在瘢痕组织形成时会引发导致补片收缩的炎症反应。此外,慢性疼痛与补片固定技术之间的关系仍存在一些问题。为了减少这些缺点,我们研发了一种用于前路无张力腹股沟疝修补的新型补片,它具有自固定可吸收特性。

材料与方法

52例患者(69处疝)前瞻性地使用了这种由法国索弗拉迪姆公司生产的补片,该补片由低重量等弹性大孔针织织物制成,其中包含可吸收微钩,在植入后的头几个月为补片提供自固定特性。补片固定到组织上明显更容易。补片通过自固定瓣围绕精索固定。在组织完全长入且聚乳酸钩吸收后,低重量(40克/平方米)聚丙烯补片确保长期加固腹壁。

结果

手术过程中,未报告并发症,补片易于操作和固定。术后第1天即可出院。未发生围手术期并发症,术后第5.5天即可恢复日常活动。1个月时,未出现神经痛或其他并发症。

结论

基于这项临床研究的初步结果,这种低密度自固定补片的独特概念应能有效治疗腹股沟疝。它应能减少术后并发症和所需缝线固定的程度,使手术更具可重复性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6570/2999773/170b7c937d64/JMAS-02-139-g001.jpg

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