Liu Jing, Zhai Zhiwei, Chen Jie
1 Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China.
Surg Innov. 2019 Jun;26(3):344-349. doi: 10.1177/1553350619828900. Epub 2019 Feb 8.
Tension-free hernia repair has been regarded as a gold standard treatment for selected inguinal hernias, but the use of prosthetic mesh in acute incarcerated inguinal hernias is controversial. Our study focused on evaluating the safety and efficacy of the prosthetic mesh repair for emergency cases.
Patients with acute incarcerated inguinal hernias who underwent emergency prosthetic mesh repair during 2009 to 2014 at our department were included. Patient characteristics, operative approaches and results, and complications were retrospectively analyzed.
A total of 167 patients were included in our study. One hundred and twenty-two patients underwent open surgery while the remaining 45 patients underwent transabdominal preperitoneal laparoscopic approach. The hernia was indirect inguinal in 133 patients (79.6%), direct inguinal in 15 patients (9.0%), and femoral in 19 patients (11.4%). The overall wound infection rate of these patients was 3%. Nonviable intestinal resection was performed in 25 patients (8.4%), only 2 of whom underwent wound infection. Another 3 patients who developed wound infection had viable hernia content. There was no mesh-related infection. There was no statistically significant difference in wound infection rates between patients with viable hernia contents and those with nonviable contents ( P < .05).
The use of the prosthetic mesh in the treatment of acute incarcerated inguinal hernia is safe and effective. Nonviable intestinal resection cannot be regarded as a contradiction of the mesh repair.
无张力疝修补术被视为特定腹股沟疝的金标准治疗方法，但在急性嵌顿性腹股沟疝中使用人工补片存在争议。我们的研究聚焦于评估人工补片修补术在急诊病例中的安全性和有效性。
纳入2009年至2014年在我科接受急诊人工补片修补术的急性嵌顿性腹股沟疝患者。对患者的特征、手术方式及结果、并发症进行回顾性分析。
我们的研究共纳入167例患者。122例患者接受开放手术，其余45例患者接受经腹腹膜前腹腔镜手术。133例患者（79.6%）为腹股沟斜疝，15例患者（9.0%）为腹股沟直疝，19例患者（11.4%）为股疝。这些患者的总体伤口感染率为3%。25例患者（8.4%）进行了坏死肠段切除，其中仅2例发生伤口感染。另外3例发生伤口感染的患者疝内容物存活。未发生与补片相关的感染。疝内容物存活的患者与疝内容物坏死的患者之间伤口感染率无统计学显著差异（P <.05）。
在急性嵌顿性腹股沟疝治疗中使用人工补片是安全有效的。坏死肠段切除不能被视为补片修补术的禁忌证。
