复发性腹股沟疝

对疝修补具有浓厚兴趣和丰富经验的Nyhus、Glassow、McVay等所报道的疝修补术后复发率都很低,如腹股沟直疝修补术的复发率仅为0.25%～3%.但Berliner、Katz等认为在相当多的失访病人中,实际存在疝复发,随着时间的推移,失访愈多复发率可能愈高.Postlethwait报道直疝5年内的复发率为57%,10年后为78%,余下的22%将在术后10～40年内复发.     

Recurrent inguinal hernia

The problem of recurrent inguinal hernia is still open. The authors after an analysis of the main causes of recurrences, show the fact that the reoperations employing the traditional techniques can present a risk of further recurrence much higher then the first operation. The use of properitoneal prosthesis through a median approach, can considerably lower the risk of recurrence.     

Recurrent inguinal hernia: a personal study

A personal series of 287 recurrent inguinal hernias repaired by a single consultant surgeon is presented. Four techniques of repair were employed in the series: Bassini operation; a posterior 'lace repair'; complete closure of the canal after division of the spermatic cord and local repair of isolated defects. The overall recurrence rate, 27 failures in 287 operations (9 per cent) is disappointing. The best technique is excision of the cord and canal closure, two failures in 43 operations (5 per cent). Cord excision does carry a risk of testicular complications.     

Recurrent inguinal hernia.

An analysis of 584 operations for recurrent inguinal hernia was made in an attempt to determine the cause of the recurrence based on the anatomic findings. The recurrence was indirect in 300, direct in 241, and various other in 43 operations. The causes of the indirect recurrences appeared to be an unrecognized hernia, incomplete dissection or improper ligation of the sac, failure to narrow the cord, or inadequate reconstruction of the internal ring. No cause for the diffuse direct recurrences was apparent. Of the 241 hernias in Hesselbach's triangle, 144 were small localized defects, usually (112) just lateral to the symphysis. These were considered to be caused by the cutting action of a suture placed under tension. On the basis of these findings, suggestions are made for primary inguinal hernia operations.     

Recurrent inguinal hernia treated by classical hernioplasty

The treatment of recurrent inguinal hernia by classical hernioplasty, ie, via the anterior approach and using endogenous tissue for repair, was evaluated in 163 patients operated on between 1980 and 1987. One hundred fifteen patients had a first recurrence and 48 had a multiple recurrence; 58% were of the direct type; 30% were of the indirect type; 7% were of the combined type; and 5% were not defined. In 1989 a questionnaire was sent to all patients; those indicating symptoms of recurrence underwent further examination. There was a mean follow-up of 52 months and a total follow-up period of 706 years. Thirty-seven patients had a repeated recurrence with a cumulative recurrence rate of 16%, 21%, and 23%, after 1, 2, and 5 years, respectively. Increase of age and time passed since the last repair reduced the recurrence rate. Increased abdominal pressure, type of anesthesia or surgical technique, and wound hematoma had no effect. It is concluded that the technique of classical hernioplasty as such may be unsuitable for repair of recurrent inguinal hernias.     

Recurrent incarceration of left interstitial inguinal hernia

A new method for skin grafting is presented, depending upon the principles of tissue culture, namely, the fixation of the graft by means of a thin coagulum of autogenous plasma. No stitches or pressure dressings are necessary.Besides the clinical work, further experimental animal work is in progress to simplify the method and broaden its application.     

Recurrent inguinal hernia: Follow-up study of 100 postoperative patients

This review of recurrent inguinal hernia evaluates the possible causes of recurrence and the most effective operative procedures for successful repair. Emphasis is placed upon precise dissection technic so that whatever fascia is available after the primary operation may be utilized for the subsequent repair. A detailed study is devoted to the histologic features of fascia, emphasizing its lack of vascularization as the possible reason for its strength and permanency throughout life. In operations for recurrent inguinal hernia, rectus sheath pedunculated grafts should be used more frequently, and in extreme cases cord excision may be required. A follow-up study of one hundred postoperative cases, with a failure rate of 7 per cent, is presented.     

Intestinal erosions following inguinal hernia repair: a systematic review

Hernia - To sum all available evidence regarding mesh or mesh fixation material intestinal erosion following inguinal hernia repair and identify the parameters that lead to early...     

Recurrent inguinal hernia due to mesh dissolution: two case reports

The recurrence of inguinal or other abdominal hernia due to Prolene polypropylene mesh dissolution has never been reported in the literature. This is a report of two cases of recurrent inguinal hernias after mesh hernioplasty, but, on exploration, no mesh was found.     

Open repair of inguinal hernia: an evidence-based review

This article provides an evidence-based review of open hernia repair. Technical considerations in general, including perioperative management of the patient, and the most currently used open repairs are addressed. Outcomes after repair are reviewed using the latest available literature. Current recommendations from this review include the routine use of mesh in primary repair of inguinal hernia and the need to counsel patients preoperatively about the risk of chronic postoperative groin pain.     

Recurrent inguinal hernia: randomized multicenter trial comparing laparoscopic and Lichtenstein repair

Background The optimal treatment for recurrent inguinal hernia is of concern due to the high frequency of recurrence. Methods This randomized multicenter study compared the short- and long-term results for recurrent inguinal hernia repair by either the laparoscopic transabdominal preperitoneal patch (TAPP) procedure or the Lichtenstein technique. Results A total of 147 patients underwent surgery (73 TAPP and 74 Lichtenstein). The operating time was 65 min (range, 23–165 min) for the TAPP group and 64 min (range, 25–135 min) for the Lichtenstein group. Patients who underwent TAPP reported significantly less postoperative pain and shorter sick leave (8 vs 16 days). The recurrence rate 5 years after surgery was 19% for the TAPP group and 18% for the Lichtenstein group. Conclusion The short-term advantage for patients who undergo the laparoscopic technique is less postoperative pain and shorter sick leave. In the long term, no differences were observed in the chronic pain or recurrence rate.