Rutkow I M, Robbins A W
Hernia Center, Freehold, NJ 07728.
Surgery. 1993 Jul;114(1):3-8.
Since 1984 we have completed 3897 inguinal herniorrhaphies. This article compares our results with a conventional Cooper ligament repair versus the "mesh hernia plug" method.
From 1984 through 1988 we performed 2886 conventional Cooper ligament repairs. From 1989 through 1991 we completed 1011 mesh hernia plug repairs.
Despite an acceptable recurrence rate (1.8%), we abandoned the Cooper ligament technique because of persistent difficulties with immediate postoperative pain, inability to reasonably resume day-to-day activities, delayed capacity regarding return to work, and four cases of femoral vein compression. Of the hernias repaired by the mesh plug method, the recurrence rate remains remarkably low (0.2%), and except for four superficial infections and three cases of urinary retention, no other significant complications have been reported.
Compared with conventional sutured surgical techniques, a plug repair uses less overall dissection and ensures a "tension-free" hernioplasty. We believe that the two factors of no tissue tension and decreased dissection are the most important reasons for greater patient comfort, rapid rehabilitation, decreased recurrence, and lessened overall complication rates with the mesh hernia plug technique.
自1984年以来，我们已完成3897例腹股沟疝修补术。本文将我们采用传统库珀韧带修补术与“疝修补补片”方法的结果进行了比较。
1984年至1988年，我们进行了2886例传统库珀韧带修补术。1989年至1991年，我们完成了1011例疝修补补片修补术。
尽管复发率可接受（1.8%），但由于术后立即出现的疼痛持续存在、无法合理恢复日常活动、恢复工作延迟以及4例股静脉受压，我们放弃了库珀韧带技术。在采用补片方法修补的疝中，复发率仍然极低（0.2%），除4例浅表感染和3例尿潴留外，未报告其他重大并发症。
与传统的缝合手术技术相比，补片修补术所需的整体解剖较少，并确保了“无张力”疝修补术。我们认为，无组织张力和解剖减少这两个因素是采用疝修补补片技术能让患者更舒适、康复更快、复发率降低以及总体并发症发生率降低的最重要原因。
