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改良免固定补片技术联合新型 3D 多层植入物治疗腹股沟疝:单中心回顾性病例系列研究。

Modified fixation free plug technique using a new 3D multilamellar implant for inguinal hernia repair: a retrospective study of a single operator case series.

机构信息

Department of General Surgery, Urgency and Organ Transplantation, University of Palermo, Via Rapisardi 66, 90144, Palermo, Italy,

出版信息

Hernia. 2014 Apr;18(2):243-50. doi: 10.1007/s10029-013-1102-y. Epub 2013 May 8.

Abstract

AIM

Implant fixation, mesh shrinkage and poor quality of tissue ingrowth are unresolved issues in modern hernia repair. Many complications reported in the literature such as bleeding, nerve entrapment, hematoma, pain, discomfort, and testicular complications, are considered to be a direct results of implant fixation. This article describes the outcomes of a procedure carried out using a handcrafted implant that addresses the issues consequent to point fixation.

METHODS

This was a retrospective study on the short, medium and long-term results of placing a-modified, fixation free three-dimensional polypropylene implant in 61 patients who underwent inguinal hernia repair using a novel delivery technique. The follow up length was at least 36 months postop.

RESULTS

Only minor adverse events and a low complication rate of the procedure were observed in this patient sample. There were no long- term complications. Postoperative pain was very low in both the short and long term. No chronic pain was reported. No recurrences occurred.

CONCLUSION

The results of this retrospective study on a new method of inguinal hernia repair using a three dimensional handcrafted multilamellar implant delivered with a modified placement technique are promising. The short-, medium- and long-term complications were notably low. No recurrences were noticed but, more importantly, no chronic pain and extremely low discomfort rates were observed even in the long term.

摘要

目的

在现代疝修补术中,植入物固定、网片收缩和组织内生长不良仍然是尚未解决的问题。许多文献中报道的并发症,如出血、神经嵌压、血肿、疼痛、不适和睾丸并发症,被认为是植入物固定的直接结果。本文描述了一种使用手工制作植入物进行手术的结果,该植入物解决了因固定点引起的问题。

方法

这是一项回顾性研究,对使用新型递送技术对 61 例腹股沟疝患者进行改良、无固定三维聚丙烯植入物置入的短期、中期和长期结果进行了评估。随访时间至少为术后 36 个月。

结果

在该患者样本中,仅观察到轻微的不良事件和较低的手术并发症发生率。无长期并发症。术后短期和长期疼痛均很低。无慢性疼痛报告。无复发。

结论

使用改良放置技术递送三维手工制作多层植入物治疗腹股沟疝的新方法的回顾性研究结果令人鼓舞。短期、中期和长期并发症明显较低。虽然没有复发,但更重要的是,即使在长期随访中,也观察到极低的慢性疼痛和不适发生率。

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