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目的总结1997年11月至2011年12月复旦大学附属华东医院开展开放式腹股沟疝无张力修补术4438例的临床经验。方法根据各种不同类型的开放式腹股沟疝无张力修补术,对4438例腹股沟疝采用相对应的不同补片进行手术治疗,对不同术式的手术时间、术后疼痛、疝复发、血肿、血清肿、慢性疼痛、生殖系统并发症等及其他相关并发症进行观察、总结及数据分析。结果无手术死亡病例。术后平均随访33.7个月,术后血肿18例(0.40%),血清肿45例(1.01%),切口感染或愈合不良16例(0.40%),缺血性睾丸炎3例(0.07%)。复发14例(0.32%),慢性疼痛7例(0.60%),异常勃起1例(0.02%);3例睾丸疼痛(0.07%)。结论开放式无张力疝修补术治疗腹股沟疝安全有效,不同术式的疗效及并发症发生率情况接近,开展技术早期需特别注意预防手术并发症,对不同的病例宜采用个体化治疗方案,以期达到最佳的治疗效果。

Open tension-free hernia repair for inguinal hernia:a report of 4438 cases

Objective To summarize the clinical experience of 4438 cases of open tension-free hernia repair operation performed from November 1997 to December 2011 at Huadong Hospital Affiliated to Fudan University. Methods All the cases were treated with different operation of different mesh. The operation procedure,postoperative pain,recurrency rate and other complications were studied and analyzed. Results There was no dead case. The mean follow up was 33.7 months. In all the cases,there were 18 cases of postoperative hematoma(0.40%) ,45 cases of seroma(1.01%) ,16 cases of incisional infection(0.40%) ,3 cases of ischemic orchitis(0.07%) ,14 cases of recurrency(0.32%) ,1 case of priapism(0.02%) ,3 cases of testicular pain(0.07) . Conclusion Open tension-free repair is safe and effective for inguinal hernia cases. Different methods have similar clinical outcomes. Postoperative complications should be prevented in one’s earlier experience. Different operations for different cases should be performed for the best effective.