Ali Mahamudu Ayamba, Hagbevor Israel, Kyei Mathew Yamoah, Nanga Salifu
Department of Surgery, School of Medicine, University of Health and Allied Science. Ho, Volta Region, Ghana.
Surgical Unit, Margaret Marquart Catholic Hospital, Kpando, Volta region, Ghana.
Ann Med Surg (Lond). 2021 Oct 16;71:102964. doi: 10.1016/j.amsu.2021.102964. eCollection 2021 Nov.
Complicated appendix is a least expected sac content of inguinal hernias that always require appendix surgery and hernia repair. The current recommendations for posterior wall repairs however, continue to attract conflicting views as to which modality gives the best outcome in infected surgical wounds. New posterior wall repair methods with properties to withstand surgical site infections, minimise hernia recurrence, affordable and easy skill to acquire with a potential to be widely adopted are continuosly sort.
To determine the surgical outcomes of complicated Amyand Hernias repaired using the open tissue base Nylon Darn posterior wall re-enforcement method.
A retrospective review of medical records of patients who had surgery for emergency inguinal hernia with intra-operative confirmation of complicated appendix in the hernia sac from January 2015 to December 2020 at the Margaret Marquart Catholic Hospital, Kpando were included. Data on age, sex, clinical presentation, surgical procedure, intra-operative findings, post operative complications were captured and presented as descriptive statistics.
Twelve out of 286(4.6%) repairs were complicated Amyand Hernias in patients aged 6weeks to 76-years{median age 54.5-years}. Most of them were adults, long-standing hernias. All diagnosis were made on-table. Surgical site infections was the most frequent complication in types III and IV AHs which resolved with antibiotic treatment.
The incidence of complicated AHs is higher and should be anticipated in surgeries for long-standing complicated inguinal hernias. Even though complications were significantly associated with longer hospital stay, no second procedure or mortality was recorded.
复杂阑尾炎是腹股沟疝最意想不到的疝内容物，总是需要进行阑尾手术和疝修补术。然而，目前关于后壁修补的建议，对于哪种方式在感染手术伤口中能取得最佳效果仍存在相互矛盾的观点。人们一直在寻找具有抵抗手术部位感染、使疝复发最小化、价格合理且易于掌握并有可能被广泛采用等特性的新型后壁修补方法。
确定采用开放组织基底尼龙补片后壁加强法修复复杂阿米亚德疝的手术效果。
回顾性分析2015年1月至2020年12月在克潘多玛格丽特·马尔夸特天主教医院接受急诊腹股沟疝手术且术中证实疝囊内有复杂阑尾炎的患者的病历。收集患者的年龄、性别、临床表现、手术方式、术中发现、术后并发症等数据，并以描述性统计呈现。
286例修补中有12例（4.6%）为复杂阿米亚德疝，患者年龄在6周至76岁之间（中位年龄54.5岁）。大多数为成年人，疝存在时间较长。所有诊断均在手术台上做出。手术部位感染是III型和IV型阿米亚德疝最常见的并发症，经抗生素治疗后痊愈。
复杂阿米亚德疝发生率较高，在长期复杂腹股沟疝手术中应予以预期。尽管并发症与住院时间延长显著相关，但未记录到二次手术或死亡情况。
