Combined transurethral resection of prostate and inguinal mesh hernioplasty

We aimed to evaluate the difference among early post-operative morbidities of transurethral resection of prostate (TURP), inguinal herniorrhaphy and their combination in this study. Between 1998 and 2004, 44 patients undergoing combined inguinal herniorrhaphy and TURP (Group I) were compared with 50 consecutive cases of TURP alone (Group II) and 50 consecutive cases of inguinal herniorrhaphy alone (Group III). There were no differences in the mean age and mean prostatic volume between Group I and II. The mean operation time and length of hospital stay were 126.1 +/- 20.9 min, 3.0 +/- 0.7 days for Group I, 61.4 +/- 15.6 min and 2.9 +/- 0.69 days for Group II and 55.0 +/- 15.6 min and 1.2 +/- 0.4 days for Group III, respectively. The mean operation time of Group I was found as longer than Group II and III. There were no significant differences among all groups regarding post-operative complications. No mesh infection was detected. Combined TURP and inguinal herniorrhaphy is a practical, safe and effective procedure.     

经尿道前列腺电切同期行无张力疝修补术的临床观察

目的：探讨对良性前列腮增生合并腹股沟疝患者,在经尿道前列腺电切术的同期行疝环填充式张力疝修补术（Mesh Plug疝修补术）的效果。方法：对37例良性前列腺增生症合并腹股沟疝者,在行经尿道前列腺电切术的同时行Mesh Plug疝修补术。结果：37例手术均顺利。术后随访6-24个月,无一例疝复发,排尿通畅,控尿良好。结论：经尿道前列腺电切同期行Mesh Plug疝修补术效果满意,手术简单,安全可靠,无严重并发症。     

Prostatism and inguinal hernia

We reviewed a series of 70 patients who had transurethral resection of the prostate to determine the incidence of inguinal hernia. We found inguinal hernias in 20% of the patients, a figure significantly higher than in the general population. In 47% of the patients a hernia was present on admission or herniorrhaphy had been done previously. Urine flow rate has been previously found to be an excellent screening measurement for prostatism, a concept confirmed by this series. Because benign prostatic hyperplasia has associated morbidity and because its presence is not desirable in patients having herniorrhaphy, urine flow rate is advocated as a routine screening test for prostatism in patients with inguinal hernias.     

TUVP+无张力疝修补术治疗BPH并腹股沟疝(附22例报告)

目的：探讨BPH合并腹股沟疝病人同期行TUVP＋无张力疝修补术治疗的方法及优越性,可行性.方法：报告经治的22例BPH合并腹股沟疝的临床资料.结果：22例手术时间55～120分钟,术中出血少平均70mL,无TURS（经尿道电切综合征）及其他并发症发生,伤口无感染,术后5～7天出院.22例随访3～36月,排尿通畅,无疝复发.结论：TUVP＋无张力疝修补术同期治疗BPH合并腹股沟疝,疗效好,创伤小,术后恢复快,对老年人更有意义.     

同期施行经尿道前列腺汽化电切术及无张力疝修补术29例临床分析

目的：探讨良性前列腺增生症（BPH）合并腹股沟疝的一次性手术的方法和效果。方法：先行疝环填充式无张力疝修补术,同期再行经尿道前列腺汽化切除术（TUVP）,一次性手术治疗BPH合并腹股沟疝病人29例。结果：手术过程顺利,术后恢复快。29例均获随访,时间为1－40个月,无疝复发;术后国际前列腺症状评分（IPSS）〈8分,最大尿流率（MFR）〉15mL／s。结论：同期行TUVP及无张力疝修补术治疗BPH合并腹股沟疝,操作简单、安全可靠、疗效肯定,可避免二次麻醉、二次手术的痛苦、风险以及经济负担。     

腹膜前单层网片无张力疝修补术临床应用

目的 探讨经腹膜前单层网片无张力疝修补术的临床疗效.方法 回顾性分析解放军411医院2008年1月至2012年12月356例患者采用经腹膜前单层网片无张力疝修补术的临床资料.结果 全组患者术后均痊愈,无局部异物感,无感染,随访无复发.结论 经腹膜前单层网片无张力疝修补术是对腹股沟区的全面修补,该手术是一种安全有效的手术方式,是治疗腹股沟疝的一种合理的手术方式.     

无张力疝修补术治疗腹股沟疝45例

目的探讨无张力疝修补术治疗腹股沟疝的临床疗效。方法对45例腹股沟疝患者采用无张力疝修补术治疗。术中采用普理灵疝装置进行修补。结果 45例患者中,手术时间35～90 min,平均（44.9±4.9）min。术后6～12 h即可进食及下床活动。术后阴囊轻度肿胀6例,局部轻微疼痛、牵拉感5例,无切口感染。术后4～7 d痊愈出院。45例患者术后随访6～24个月,无一例复发。结论采用普理灵疝装置行无张力疝修补术治疗腹股沟疝具有操作简便、损伤小、术后并发症少及复发率低等优点,是一种较好的术式。     

膀胱癌并前列腺增生经尿道同期电切术的临床观察

【目的】探讨膀胱癌并前列腺增生症患者同期行经尿道膀胱肿瘤加前列腺电切术治疗的可行性及疗效。【方法】对27例膀胱癌并前列腺增生患者，行同期经尿道膀胱肿瘤加前列腺电切术并随访观察疗效。【结果】随访5～60个月，5例术后复发，平均19个月，无尿道及前列腺窝种植转移。【结论】膀胱癌并前列腺增生患者同期行经尿道电切术疗效确定，未观察到有前列腺窝及尿道种植转移。     

改良Kugel修补术在腹股沟疝中的临床应用

目的：探讨改良Kugel修补术在治疗腹股沟疝中的临床应用。方法：回顾性分析我院2012—09—2013—09采用改良Kugel术式修补的腹股沟疝患者55例。观察患者手术时间、住院时间、术后并发症及复发情况。结果：55例均治愈。手术时间（54±15）rain,住院时间（4±1．5）d,术后恢复快,无切口感染、出血、阴囊水肿等并发症。随访6个月,无1例复发。结论：改良Kugel修补术是一种安全有效的微创、无张力疝修补术式,手术时间短,术后恢复快,并发症少,复发率低。     

Emergency repair of groin herniae: outcome and implications for elective surgery waiting times

Patients with groin herniae do not always seek medical advice and, when listed for surgery, often wait many months for elective repair. We audited our emergency admissions for complicated groin herniae to establish whether a change in policy for elective surgery could lower their incidence. We performed a retrospective review of all admissions for complicated groin herniae from 1 January 2000 to 31 December 2001. Besides outcome, we recorded patients' awareness of their diagnosis before admission and whether they had been listed for elective surgery. We identified 19 patients (16 men and three women) with an inguinal and 19 (four men and 15 women) with a femoral hernia. Sixteen (42%) knew of their hernia before admission (11 inguinal and five femoral), but only three had been awaiting surgical repair for 1, 7 and 26 weeks, respectively. The median (interquartile range) age was 70 (54-84) years in inguinal and 79 (64-88) years in femoral herniae. Surgery was performed in all but an 84-year-old man who died pre-operatively. Two patients with inguinal and 11 with femoral herniae required a laparotomy (p = 0.006). Bowel resection was necessary in one patient with an inguinal and 12 with femoral herniae (p = 0.001). Complications occurred in 12 cases (31%). Four patients, all with femoral herniae, died post-operatively, for an overall mortality of 13% (5/38). Morbidity and mortality for complicated groin hernia, particularly femoral, remain high. As most patients were elderly and unaware of their diagnosis, reducing waiting times for elective repair is unlikely to influence the incidence of complicated herniae.     

两种无张力疝修补术在治疗成人腹股沟斜疝中的对比

目的 比较开放式无张力疝修补术与腹腔镜疝修补术在治疗成人斜疝中的疗效差异。方法 回顾性分析和比较1999年1月～2004年7月，完成的两种不同无张力成人斜疝修补术172例（A组：开放式无张力修补术90例，B组：腹腔镜无张力修补术82例）的手术并发症、术后恢复情况、费用及复发率等。结果 两种术式复发率差异无显著性，B组术后恢复快于A组，手术并发症B组少于A组，费用B组高于A组。结论 两种疝修补术在治疗成人斜疝中均疗效确切，复发率低；腹腔镜疝修补术虽有很多优点，并可作为双侧疝、复发疝、滑动性疝、下腹部有手术疤痕等疝患者的首选，但还不能完全取代开放式无张力疝修补术，选用何种手术方式应个体化。     

两种方法治疗腹股沟疝的临床观察

[目的]探讨疝环充填式无张力疝修补术与传统方法治疗腹股沟疝临床效果及术后护理。[方法]回顾性分析总结我科2001年1月—2008年1月收治的118例腹股沟疝病人的临床资料，其中76例应用无张力疝修补术修补腹股沟疝，42例行传统手术。[结果]无张力疝修补术与传统修补术病人术后止痛剂使用率、尿潴留发生率、阴囊积液发生率、复发率、住院天数、下床活动及进食时间方面比较，差异均有统计学意义（P〈0.05）。[结论]疝环充填式无张力修补术可有效降低腹股沟疝的复发和并发症的发生，减轻病人痛苦。     

两种方法治疗腹股沟疝的临床观察

[目的]探讨疝环充填式无张力疝修补术与传统方法治疗腹股沟疝临床效果及术后护理.[方法]回顾性分析总结我科2001年1月-2008年1月收治的118例腹股沟疝病人的临床资料,其中76例应用无张力疝修补术修补腹股沟疝,42例行传统手术.[结果]无张力疝修补术与传统修补术病人术后止痛剂使用率、尿潴留发生率、阴囊积液发生率、复发率、住院天数、下床活动及进食时间方面比较,差异均有统计学意义(P<0.05).[结论]疝环充填式无张力修补术可有效降低腹股沟疝的复发和并发症的发生,减轻病人痛苦.     

TAPP和Kugel疝修补术临床效果比较分析

目的比较TAPP和Kugel手术方式在治疗成人腹股沟疝中的效果。方法将152例患者随机分成两组,一组接受TAPP手术,另一组接受Kugel手术,比较两组短期并发症,手术时间及住院时间等方面的指标。结果 TAPP组术后1周并发症明显少于Kugel组(χ2=0.83,P<0.05);手术时间、术后住院时间较Kugel组缩短(t分别=1.99、2.36,P均<0.05);TAPP组术后疼痛程度较轻,使用止痛药物次数较少(χ2=1.72,P<0.05)。结论 TAPP术是一种更为简单、微创、安全,恢复快的手术方式。     

102例腹腔镜下完全腹膜外疝修补术的临床分析

目的探讨腹腔镜下完全腹膜外疝修补术（TEP）的经验。方法回顾分析2007年9月～2012年3月102例TEP术,观察手术时间、术后舒适性、并发症和复发率。结果102例手术均顺利完成,住院时间3～13d,平均5d,随访6个月～2年,3例复发。结论TEP是一个微创的、无张力的腹股沟疝修补术,手术安全可靠,术后疼痛轻,住院时间短,恢复快,复发率及并发症低。     

TVP: A cheaper and effective alternative to TURP

Summary

Transurethral electrovaporization of the prostate (TVP) is a new minimally invasive procedure to treat enlargement of the prostate. It was the aim of this study to compare the efficacy, post-operative morbidity and costs of transurethral resection (TURP) with TVP of the prostate. Forty men requiring a transurethral resection of the prostate over a period of 12 months were randomly selected to undergo either TURP (20 men) or TVP (20 men). The improvement in the urinary symptoms and peak urinary flow of the two groups were measured before and after surgery. The post-operative morbidity, hospital stay, operating time and the costs of the two procedures were analysed in detail. Both TURP and TVP were found to have the same efficacy in relieving prostatic symptoms and obstruction with a successful surgical outcome in 85% of the men. The mean hospital stay for the TVP group (1.85 days) was significantly lower than the TURP group (3.5 days) as were the postoperative bladder irrigation and catheterization time (P < 0.0001). TVP was significantly cheaper than TURP due mainly to the reduced hospital stay, blood transfusions and cost of bladder irrigants. The overall morbidity was less for the TVP group (10%) in comparison to TURP (15%). TVP is as effective as TURP in relieving prostatic symptoms while being less morbid and cheaper with a shorter hospital stay: probably a better alternative to TURP.     

同期手术治疗前列腺增生合并腹股沟疝的效果评价*

目的探讨经尿道前列腺增生等离子电切术(PKURP)联合腹腔镜全腹膜外腹股沟疝修补术(TEP)同期治疗良性前列腺增生(BPH)合并腹股沟疝的临床效果。方法回顾分析在该院接受手术治疗的59例BPH合并腹股沟疝患者临床资料,其中接受先行PKURP再次行TEP分期手术患者(对照组)28例;接受行同期行PKURP联合TEP手术患者(观察组)31例,对比两组手术时间、出血量、手术成功率、术后并发症及复发率情况。结果两组PKURP和TEP的手术时间及手术成功率比较,差异无统计学意义(P0.05);观察组术中出血量较对照组明显减少,总住院时间、总体费用均明显低于对照组,差异均有统计学意义(均P0.05);两组术后并发症比较差异无统计学意义(P0.05)。结论 PKURP联合TEP同期治疗BPH合并腹股沟疝安全有效,且能够减少患者出血量,节省医疗费用,同时避免二次手术和麻醉的创伤及痛苦,尤其对老年及手术耐受差患者具有积极意义。     

Indirect inguinal hernia containing portosystemic shunt vessel: A case report

BACKGROUNDInguinal hernia repair is one of the most common general surgical operations worldwide. We present a case of indirect inguinal hernia containing an expanded portosystemic shunt vessel.CASE SUMMARYWe report a 72-year-old man who had a 4 cm × 4 cm swelling in the right inguinal region, which disappeared with light manual pressure. Abdominal-pelvic computed tomography (CT) revealed a right inguinal hernia containing an expanded portosystemic shunt vessel, which had been noted for 7 years due to liver cirrhosis. We performed Lichtenstein’s herniorrhaphy and identified the hernia sac as being indirect and the shunt vessel existing in the extraperitoneal cavity through the internal inguinal ring. Then, we found two short branches between the expanded shunt vessel and testicular vein in the middle part of the inguinal canal and cut these branches to allow the shunt vessel to return to the extraperitoneal cavity of the abdomen. The hernia sac was returned as well. We encountered no intraoperative complications. After discharge, groin seroma requiring puncture at the outpatient clinic was observed.CONCLUSIONIf an inguinal hernia patient has portal hypertension, ultrasound should be used to determine the contents of the hernia. When atypical vessels are visualized, they may be shunt vessels and additional CT is recommended to ensure the selection of an adequate approach for safe hernia repair.     

部分小肠微创切除在绞窄性腹股沟疝患者中的应用研究

目的探讨腹腔镜部分小肠切除术联合开放式无张力疝修补对绞窄性腹股沟疝患者的应用研究。方法选取2008年1月-2015年12月于该院收治的98例绞窄性腹股沟疝患者作为研究对象,根据手术方案分为微创组(n=41,腹腔镜部分小肠切除术联合开放式无张力疝修补术)和开腹组(n=57,开放式小肠切除术联合Bassini修补术)。比较两组术前基线资料、手术时间、术后并发症、术后住院天数、生存状况和疝复发率。结果两组术前基线资料比较,差异均无统计学意义(P0.05),具有可比性。微创组的术后慢性疼痛不适的发生率、复发率均明显低于开腹组,差异均有统计学意义(P0.05)。两组的手术时间、切口感染、腹股沟淤血或血肿发生率、术后住院天数和围手术期死亡率等资料比较,差异均无统计学意义(P0.05)。结论对绞窄性腹股沟疝患者而言,腹腔镜部分小肠切除术联合开放式无张力疝修补术不仅能充分利用无张力补片修补的优点,并避免了肠管切除对补片的污染,降低了感染和复发风险,值得临床推广应用。     

无张力疝修补术治疗腹股沟复发疝32例分析

目的探讨无张力疝修补术在治疗腹股沟复发疝中的作用。方法回顾性分析2002年10月至2006年10月收治的腹股沟复发疝32例的手术经验,术中采用网塞补片装置(mesh plug-patch)行无张力疝修补。结果本组患者全部治愈,术后出现3例阴囊血肿。随访1~48个月未见复发病例。结论无张力疝修补术治疗腹股沟复发疝,安全、简单、有效。