Department of General surgery, Fujian Medical University Union Hospital, Fuzhou, Fujian, PR China.
Department of General surgery, Fujian Medical University Union Hospital, Fuzhou, Fujian, PR China.
J Visc Surg. 2020 Oct;157(5):372-377. doi: 10.1016/j.jviscsurg.2020.01.007. Epub 2020 Jan 31.
Giant inguinoscrotal hernias are rarely encountered in clinical settings, and their repair is technically challenging. The aim of this study is to evaluate the efficacy of transinguinal preperitoneal repair (TIPP) of giant inguinoscrotal hernias using Kugel mesh.
A retrospective analysis was conducted on 9 patients with 11 giant inguinoscrotal hernias who underwent TIPP repair using Kugel mesh between December 2008 and January 2019. Demographics and perioperative and postoperative data were collected, and the operative experience was summarized.
The patients underwent a successful repair procedure with simultaneous omentectomy but without resection of the other abdominal organs. The median operation time was 120min, the median intraoperative blood loss was 75mL and the median defect area was 72 cm. The median duration for diet restoration was 4 days, and the median postoperative hospital stay was 6 days. The drainage tube placed in the preperitoneal space was removed after a median duration of 5 days, and the drainage tube placed in the distal hernia sac was removed after a median duration of 6 days. Three patients suffered from a postoperative increase in intra-abdominal pressure, while one patient deteriorated into abdominal compartment syndrome accompanied by respiratory dysfunction. No haematomas, seromas, incisional or mesh infections, recurrence or chronic pain occurred during the follow-up period.
TIPP repair using Kugel mesh is a feasible and effective method for giant inguinoscrotal hernias.
临床上罕见巨大腹股沟阴囊疝，其修补技术具有挑战性。本研究旨在评估 Kugel 网片经腹内环前腹膜外修补（TIPP）治疗巨大腹股沟阴囊疝的疗效。
回顾性分析 2008 年 12 月至 2019 年 1 月期间 9 例 11 例巨大腹股沟阴囊疝患者行 TIPP 修补术的临床资料。收集患者的一般资料、围手术期和术后资料，并总结手术经验。
所有患者均顺利完成手术，同时行大网膜切除术，但未切除其他腹腔脏器。手术时间中位数为 120min，术中出血量中位数为 75ml，缺损面积中位数为 72cm。术后中位恢复饮食时间为 4d，中位术后住院时间为 6d。中位 5d 后拔除腹膜前引流管，中位 6d 后拔除远端疝囊引流管。3 例患者术后出现腹腔内压增高，1 例进展为伴有呼吸功能障碍的腹腔间隔室综合征。随访期间无血肿、血清肿、切口或网片感染、复发或慢性疼痛发生。
Kugel 网片 TIPP 修补治疗巨大腹股沟阴囊疝是一种可行、有效的方法。
