Zhou Xue-Lu, Zhou Shang-Jun, Zhang Ji-Feng, Hu Hao, Zhang Jian-Feng, Cai Wei-Bin, Zhan Ping
Department of Surgery, Affiliated Dongguan Hospital, Guangzhou University of Chinese Medicine, 22 Songshanhu Avenue, Dongguan, Guandong 523003, People's Republic of China.
Department of Surgery, Affiliated Dongguan Hospital, Guangzhou University of Chinese Medicine, 22 Songshanhu Avenue, Dongguan, Guandong 523003, People's Republic of China.
Am J Surg. 2016 Nov;212(5):912-916. doi: 10.1016/j.amjsurg.2016.02.026. Epub 2016 May 11.
Despite many advantages of original Kugel hernia repair over other procedures, there exist certain disadvantages of technical difficulty, long learning curve, and high early recurrence. The aim of this study was to explore the outcomes of long-term follow-up using anterior approach preperitoneal hernia repair with the Kugel patch and determine its safety and efficacy.
Five hundred eighty-one inguinal hernias were performed in 560 patients, using anterior approach preperitoneal repair. Patients' age and sex, type of hernias, operative time, hospital stay, complications, and recurrence were evaluated.
We included 581 hernias, with 354 on right side, 162 on left side, and 65 bilateral sides. All hernias were primary. There were 443 indirect hernias, 115 direct hernias, and 23 femoral hernias. Mean operative time was 50 minutes; local anesthesia was applied in 530 cases (91.2%). Postoperative complications affected 50 patients (8.9%). The patients were discharged from 4 to 8 days (with average of 6 days). The averaged follow-up time was 70 months (12 to 120 months). There were 3 recurrences in the period (.5%).
The results of long-term follow-up with this procedure are safe and effective, easy to learn. We believe that this procedure should be adopted as an alternative method for Chinese patients with inguinal hernias.
尽管原始的库格尔疝修补术相较于其他手术有诸多优势，但仍存在技术难度大、学习曲线长和早期复发率高的缺点。本研究的目的是探讨采用库格尔补片经前路腹膜前疝修补术进行长期随访的结果，并确定其安全性和有效性。
对560例患者的581例腹股沟疝采用经前路腹膜前修补术。评估患者的年龄、性别、疝的类型、手术时间、住院时间、并发症和复发情况。
我们纳入了581例疝，其中右侧354例，左侧162例，双侧65例。所有疝均为原发性。有443例间接疝、115例直接疝和23例股疝。平均手术时间为50分钟；530例（91.2%）采用局部麻醉。术后并发症影响了50例患者（8.9%）。患者于4至8天出院（平均6天）。平均随访时间为70个月（12至120个月）。在此期间有3例复发（0.5%）。
该手术长期随访结果安全有效，易于学习。我们认为该手术应作为中国腹股沟疝患者的替代方法采用。
