嵌顿性股疝并肠坏死一期手术治疗体会

[目的]探讨嵌顿性股疝并肠坏死一期手术治疗及其临床效果.[方法]对1997年6月到2010年4月间43例嵌顿性股疝并肠坏死患者采用单一切口和双切口法一期手术治疗进行回顾性分析.手术方法为McVay疝修补术,Lichtenstein无张力疝修补术和改良Kugel疝修补术加坏死肠管切除术.研究手术方法,修补技术,术后并发症...

Experience of One-stage Operation for the Treatment of Incarcerated Femoral Hernias Complicated by Intestinal Gangrene

[Objective]To explore the one-stage surgical treatment of incarcerated femoral hernia complicated by intestinal necrosis and its clinical efficacy. [Methods]Clinical data of 43 patients with incarcerated femoral hernia complicated by intestinal necrosis treated by one-stage surgery with single incision and two incisions from June 1997 to A pril 2010 were reviewed. The surgical methods included McVay bern repair, Lichtenstein tension-free hernioplasty and modified Kugel hernia repair plus necrotic intestine resection. The surgical methods, repair technique, postoperative complications, the length of stay and recurrence were studied. [Results] The 43 patients were aged from 42 to 84 years old with the average of 62.2 years old. All of them were female. All patients accepted emergency operation due to incarceration or strangulation. Hernia contents were greater omentum and small intestine. Small intestine resection was performed due to strangulation and necrosis. Among all patients, 10 patients（group A） underwent small bowel resection plus Lichtenstein tensiowfree hernioplasty with two incisions, and 9 patients（group B） underwent small bowel resection plus modified Kugel hernia repair with two incisions, and 13 patients（group C） underwent small bow el resection plus McVay hernia repair with single incision, and 11 patients（group D） underwent small bowel resection plus McVay hernia repair with two incisions. Postoperative wound infection occurred in 1 patient in group C with sin gle incision. One patient had peritoneal exudate around drainage tube due to liver cirrhosis and ascites. No death and recurrence was found. [Conclusion]Femoral hernia is easy to be complicated with incarceration or strangulation. A1 though emergency operation can increase the risk and mortality of the surgery, early surgical treatment should be taken as soon as possible. Intestinal necrosis is easy to lead wound infection. The operation with two incisions is valu- able for decreasing the wound infection and performing one-stage surgery, so it is worthy of clinical application.