Stoppa R E
World J Surg. 1989 Sep-Oct;13(5):545-54. doi: 10.1007/BF01658869.
One hundred years ago, Edoardo Bassini said: "L'ernia é una malattia meccanica." Before that, Ambroise Paré (1598) and Joseph-Pierre Desault (1798) asserted the mechanical nature of strangulation. Beside strangulation, the most serious of all complications even today, I have studied huge hernias, which are natural complications, and recurrent hernias, which are the complications of suboptimal repairs. In this article, I consider the general features and diagnostic and technical consequences of the repair of groin and incisional hernias. The treatment of strangulating hernias, usually an emergency operation, has not seen any recent technical progress. Huge and recurrent hernias, however, usually allow time for adequate surgical preparation. These hernias are also amenable to modern prosthetic repairs. In prosthetic repairs, large pieces of polyester mesh are inserted beneath the muscular wall outside the peritoneum. They act as artificial, nonabsorbable endoabdominal fascia, making the abdominal wall instantly and definitively pressure tight. The state of hernial surgery has advanced to the point that one must consider the systematic surgical cure of all diagnosed hernias.
一百年前，爱德华多·巴西尼说过：“疝气是一种机械性疾病。”在此之前，安布鲁瓦兹·帕雷（1598年）和约瑟夫 - 皮埃尔·德索（1798年）就断言了绞窄的机械性本质。除了绞窄，即使在今天仍是最严重的并发症之外，我还研究了巨大疝（自然并发症）和复发性疝（修复欠佳的并发症）。在本文中，我将探讨腹股沟疝和切口疝修复的一般特征以及诊断和技术方面的影响。绞窄性疝的治疗通常是急诊手术，近期在技术上并无进展。然而，巨大疝和复发性疝通常有时间进行充分的手术准备。这些疝也适合现代人工材料修复。在人工材料修复中，将大片聚酯网片置于腹膜外的肌壁下方。它们起到人工、不可吸收的腹内筋膜的作用，使腹壁立即且永久地压力紧绷。疝外科手术已经发展到必须考虑对所有诊断出的疝进行系统性手术治疗的阶段。
