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改良哈氏法腹股沟疝修补术:一种新技术。

Modified Halsted's operation for inguinal hernia repair: A new technique.

作者信息

Alomar Omar Salem Khattab

机构信息

Department of General Surgery, College of Medicine, University of Baghdad, Baghdad, Iraq.

出版信息

Ann Med Surg (Lond). 2021 Oct 19;71:102968. doi: 10.1016/j.amsu.2021.102968. eCollection 2021 Nov.

Abstract

BACKGROUND

Inguinal hernia is a frequent problem presented to surgical clinic in Iraq. Surgical treatment options for inguinal hernia are numerous, selecting the appropriate method or technique depends on different factors.

AIM OF STUDY

To find a new technique for open inguinal hernia repair with no recurrence even in recurrent cases, without major complications during or after surgery, and can be used even by new surgeons with little experience.

PATIENTS & METHODS: A retrospective cross sectional study conducted in the Medical City teaching hospital and Private Hospitals in Baghdad, during the period from January 1, 2000, to December 30, 2016 on convenient sample of 408 Iraqi patients with inguinal hernia. The patients were treated by modified Halsted's technique by open surgery applying polypropylene mesh. The patients were followed up through frequent visits and phone calls to assess the recurrence and complications.

RESULTS

No recurrence of inguinal hernia was reported after 5-10 years follow up, while 94.9% of patients reported postoperative complications commonly oedema of spermatic cord. There was a highly significant association between male gender hernia patients and post Modified Halsted operation complications (p < 0.001). A highly significant association was observed between direct hernia and post Modified Halsted operation complications (p < 0.001). The significant risk factors related to complications were anemia and collagen disease.

CONCLUSIONS

The modified Halsted's operation for inguinal hernia repair is effective in treatment of inguinal hernia with low recurrence and complications rate.

摘要

背景

腹股沟疝是伊拉克外科诊所常见的问题。腹股沟疝的手术治疗选择众多,选择合适的方法或技术取决于不同因素。

研究目的

寻找一种开放腹股沟疝修补的新技术,即使在复发病例中也无复发,手术期间及术后无重大并发症,且经验不足的新外科医生也可使用。

患者与方法

2000年1月1日至2016年12月30日期间,在巴格达的医学城教学医院和私立医院对408例伊拉克腹股沟疝患者进行了一项回顾性横断面研究。采用改良的霍尔斯特德技术,通过开放手术应用聚丙烯网片对患者进行治疗。通过频繁就诊和电话随访患者,以评估复发情况和并发症。

结果

随访5 - 10年后未报告腹股沟疝复发,而94.9%的患者报告有术后并发症,常见的是精索水肿。男性疝患者与改良霍尔斯特德手术后并发症之间存在高度显著关联(p < 0.001)。在直疝与改良霍尔斯特德手术后并发症之间观察到高度显著关联(p < 0.001)。与并发症相关的显著风险因素是贫血和胶原病。

结论

改良的霍尔斯特德手术治疗腹股沟疝有效,复发率和并发症发生率低。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8bd1/8529394/43f70e8a7396/gr1.jpg

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