Chen Fuqiang, Liu Min, Jin Cuihong, Wang Fan, Shen Yingmo, Zhao Fenglin, Chen Jie
Beijing Chaoyang Hospital, Capital Medical University, Beijing, China.
The Third Clinical Medical College, Capital Medical University, Beijing, China.
Surg Innov. 2020 Aug;27(4):352-357. doi: 10.1177/1553350620901392. Epub 2020 Jan 29.
. Management of emergent groin hernias remains challenging, due to limited consensus in surgical approach and repair options (eg, mesh vs nonmesh, biological mesh, and polypropylene [PP] mesh). . A 5-year retrospective study was conducted on 118 patients who received emergency incarcerated groin hernia repair in Beijing Chaoyang Hospital. The incidence of surgical site infection (SSI), preoperative mortality, sepsis, and ileus was noted. In the follow-up, postoperative foreign body sensation, chronic pain, seroma/hematoma, and recurrence were recorded. The outcomes of different surgical procedures (with mesh/without mesh, biological mesh/PP mesh, transabdominal preperitoneal (TAPP)/Lichtenstein repair) were compared and analyzed. . Out of the 118 patients, 14 cases received suture repair (as group A); 104 cases had TAPP repair (n = 44) or Lichtenstein repair (n = 60) with meshes, including 23 cases of biological mesh (as group B); and 81 cases had repair with PP mesh (group C). There were no significant differences between the 3 groups regarding SSI, mortality, sepsis, and ileus. After 20.5 months of follow-up (range from 6 to 65 months), 21.4% of group A developed recurrence, a rate significantly higher than that of group B (4.3%) and group C (0). The incidence of seroma/hematoma in group B was higher than that in group A (7.1%) and group C (7.4%). The results between TAPP group and Lichtenstein group were comparable. . Tension-free mesh repair in the treatment of emergency incarcerated groin hernia is safe and effective, which can reduce hernia recurrence without increasing infection risk. The results of biological mesh and PP mesh were comparable.
由于手术方式和修复选择(如补片与非补片、生物补片和聚丙烯[PP]补片)方面的共识有限,急诊腹股沟疝的管理仍然具有挑战性。
对在北京朝阳医院接受急诊嵌顿性腹股沟疝修补术的118例患者进行了一项为期5年的回顾性研究。记录手术部位感染(SSI)、术前死亡率、脓毒症和肠梗阻的发生率。在随访中,记录术后异物感、慢性疼痛、血清肿/血肿和复发情况。比较并分析了不同手术方式(使用补片/不使用补片、生物补片/PP补片、经腹腹膜前修补术(TAPP)/李金斯坦修补术)的结果。
在118例患者中,14例接受了缝合修补(作为A组);104例采用补片进行TAPP修补(n = 44)或李金斯坦修补(n = 60),其中23例使用生物补片(作为B组);81例采用PP补片修补(C组)。三组在SSI、死亡率、脓毒症和肠梗阻方面无显著差异。随访20.5个月(范围为6至65个月)后,A组21.4%出现复发,该复发率显著高于B组(4.3%)和C组(0)。B组血清肿/血肿的发生率高于A组(7.1%)和C组(7.4%)。TAPP组和李金斯坦组的结果相当。
无张力补片修补术治疗急诊嵌顿性腹股沟疝安全有效,可降低疝复发率且不增加感染风险。生物补片和PP补片的结果相当。