Bierca Jacek, Kosim Anna, Kołodziejczak Małgorzata, Zmora Jan, Kultys Ewa
Department of Surgery with Subdepartment of Proctology, Hospital at Solec, Warsaw, Poland.
Wideochir Inne Tech Maloinwazyjne. 2013 Mar;8(1):36-42. doi: 10.5114/wiitm.2011.30971. Epub 2012 Oct 8.
Occurrence of giant inguinal hernias is not frequent because of growing medical awareness in the community as well as progress in surgical treatment in this field.
To evaluate the effectiveness of repairs using the Lichtenstein technique in scheduled treatment of giant inguinal hernias.
Between 2006 and 2010 in the Department of Surgery with the Subdepartment of Proctology, Hospital at Solec in Warsaw, 909 repairs of inguinal hernia were performed, including 15 patients (1.65%) with the diagnosis of giant hernia. In 3 cases it was direct inguinal hernia and in 12 cases indirect inguinal hernia. All giant hernias occurred in male patients between 33 and 87 years of age (mean age 65 years old) and developed for many years, median of 14.2 years. All patients underwent scheduled repairs using the tension-free Lichtenstein technique. A non-absorbable polypropylene mesh was used for hernioplasty. Exact Fisher's test (p < 0.01) was used for statistical analysis.
In all cases contents of the hernial sac consisted of loops of small intestine, colon and omentum. Early complications occurred in 11 patients (73%) in the group of patients with giant hernias, whereas in the remaining group of patients early complications occurred in 53 patients (5.9%). The difference was statistically significant. In the group of patients with giant hernias no recurrence was observed over the observation period ranging from 6 months to 4.5 years. In the remaining group of patients recurrences occurred in 23 patients (2.6%).
The Lichtenstein technique of repair is effective in management of giant inguinal hernias. A statistically significantly higher percentage of complications was observed in the group of patients with giant hernias as compared to the remaining group of patients with inguinal hernias. Patients with giant hernias require proper preparation for surgery, especially in relation to their respiratory efficiency.
由于社区医疗意识的提高以及该领域外科治疗的进展，巨大腹股沟疝的发生率并不高。
评估使用利希滕斯坦技术修复巨大腹股沟疝的预定治疗效果。
2006年至2010年期间，在华沙索莱克医院外科直肠病学亚科，共进行了909例腹股沟疝修补术，其中15例（1.65%）被诊断为巨大疝。3例为腹股沟直疝，12例为腹股沟斜疝。所有巨大疝均发生在33至87岁的男性患者中（平均年龄65岁），病程长达数年，中位数为14.2年。所有患者均采用无张力利希滕斯坦技术进行预定修补。使用不可吸收聚丙烯网片进行疝修补术。采用精确费舍尔检验（p < 0.01）进行统计分析。
所有病例疝囊内容物均包括小肠袢、结肠和大网膜。巨大疝患者组中有11例（73%）发生早期并发症，而其余患者组中有53例（5.9%）发生早期并发症。差异具有统计学意义。在巨大疝患者组中，观察期为6个月至4.5年，未观察到复发。在其余患者组中，有23例（2.6%）复发。
利希滕斯坦修补技术在巨大腹股沟疝的治疗中是有效的。与其余腹股沟疝患者组相比，巨大疝患者组并发症的发生率在统计学上显著更高。巨大疝患者需要进行适当的手术准备，尤其是在呼吸功能方面。
