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原发性后天性格林费尔特疝:两例新病例及文献综述

Primary acquired Grynfeltt Hernia: two new cases and literature review.

作者信息

Capasso Lorenzo, Romano Gaetano, Alderisio Antonio, Loiaco Giuseppe, Rocco Giuseppe, Massa Salvatore, De Luna Ferdinando Salzano

出版信息

Ann Ital Chir. 2018;89:255-260.

Abstract

AIM

We report two cases of the very rare Primary Acquired Grynfeltt Hernia. The related abdominal wall defects were repaired, by open surgery, placing a partially absorbable plug and mesh. The observation and management of these two new cases prompted us to review the literature with the purpose of suggesting the most appropriate surgical approach and technique.

MATHERIAL OF STUDY

A 60 years old female patient showing a swelling at the left lumbar region, and a 76 years old male patient showing evidence of a tumefaction located at the right lumbar region, were diagnosed at our department with Primary Acquired Grynfeltt Hernia.

RESULTS

Postoperative courses were uneventful and the patients were discharged from hospital respectively on the third and second postoperative day. Follow-up at thirty days, six months, two and three years showed no signs of recurrence.

DISCUSSION

Primary Acquired Grynfeltt Hernia is one of the rarest abdominal hernias. In literature there are no comparative studies showing which type of surgical approach should be preferred for this specific abdominal wall defect. In our department, open surgery was successfully performed for the treatment of two new cases of Primary Acquired Grynfeltt Hernias and, second time in literature, partially absorbable plug and mesh were placed in order to repair the causative abdominal wall defect.

CONCLUSION

Based on our experience and literature review, we consider open hernia repair with partially absorbable plug and mesh as an appropriate and advisable surgical approach for not complicated cases of Primary Acquired Grynfeltt Hernia. Surgery is performed rapidly, effortlessly and securely if the patient is under general anesthesia, in lateral decubitus position with the operating table flexed at the level of the iliac crest.

KEY WORDS

Primary Acquired Grynfeltt Hernia, Lumbar Hernia.

摘要

目的

我们报告两例极为罕见的原发性后天性格伦费尔特疝。通过开放手术,放置部分可吸收补片和网片对相关腹壁缺损进行修复。这两例新病例的观察和处理促使我们查阅文献,以提出最合适的手术方法和技术。

研究材料

一名60岁女性患者左腰区出现肿胀,一名76岁男性患者右腰区有肿物迹象,在我院被诊断为原发性后天性格伦费尔特疝。

结果

术后病程顺利,患者分别于术后第三天和第二天出院。术后30天、6个月、2年和3年的随访均未发现复发迹象。

讨论

原发性后天性格伦费尔特疝是最罕见的腹外疝之一。文献中没有比较研究表明针对这种特定腹壁缺损应首选哪种手术方法。在我院,成功地通过开放手术治疗了两例原发性后天性格伦费尔特疝新病例,并且在文献中第二次使用部分可吸收补片和网片来修复引起疝的腹壁缺损。

结论

基于我们的经验和文献回顾,我们认为对于未合并复杂情况的原发性后天性格伦费尔特疝,采用部分可吸收补片和网片进行开放疝修补术是一种合适且可取的手术方法。如果患者在全身麻醉下,采取侧卧位,手术台在髂嵴水平弯曲,手术可以快速、轻松且安全地进行。

关键词

原发性后天性格伦费尔特疝;腰疝

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