充填式无张力疝修补术治疗腹股沟疝26例体会

目的探讨充填式无张力疝修补术治疗腹股沟疝的体会。方法回顾分析我院2002年11月至2005年5月采用疝环充填式无张力疝修补术治疗腹股沟疝26例临床资料。结果26例均痊愈，术后尿潴留1例、阴囊积液1例、切口轻微红肿3例。结论疝环充填式无张力修补治疗腹股沟疝创伤小、恢复快、并发症少。     

疝环充填式无张力疝修补术在老年腹股沟疝中的应用

目的评价疝环充填式无张力疝修补术应用于老年腹股沟疝的临床效果。方法回顾性总结近5年收治的127例老年腹股沟疝患者的临床资料。结果均采用美国Bard公司生产的plugmesh定型产品行无张力疝修补术。全部病例治愈,平均手术时问40min,平均住院4.6d,随诊6~24个月,仅1例复发(复发率0.8%)。结论疝环充填式无张力疝修补术是一种完全符合生理解剖的手术。具有操作简便、创伤小、恢复快、复发率低及适应证宽等优点,适用于老年患者,尤其II型以上疝。     

疝环充填结合平片无张力修补术治疗腹股沟斜疝的疗效评价

目的研究疝环充填结合平片无张力修补术与单纯疝环充填及平片无张力修补的疗效评价。方法抽取本院自2012年1月~2014年1月87例腹股沟疝患者,随机分为三组,对照组1,对照组2和治疗组,每组29例。对照组1患者采用疝环充填式无张力疝修补术,对照组2采用平片无张力修补术,治疗组患者采用疝环充填结合平片无张力修术治疗。结果治疗组患者腹股沟疝治疗有效率,术后复发率明显优于对照组1与对照组2。结论应用疝环充填结合平片无张力修补术克服了以往疝修补术的各种弊端,手术效果明显优于对照组,值得临床广泛推广。     

老年腹股沟疝患者疝环充填式无张力修补术86例

目的总结弛环充填式无张力修补术治疗老年腹股沟疝患者的经验。方法回顾分析2002年3月-2005年7月采用德国Braun公司生产的Braun mesh和plug治疗的86例老年腹股沟疝患者的临床资料。结果平均手术时间35min，术后8-10h下床活动，2周恢复日常生活，伤口均一期愈合，术后尿潴留15例，异物感3例，随访3—40个月无一例复发。结论疝环充填式无张力修补术操作方便，创伤小，恢复快，复发率低，是老年患者理想有效的疝修补术。     

应用疝环充填式无张力疝修补术治疗腹股沟疝168例临床分析

目的 总结疝环充填式无张力疝修补术的治疗效果。方法 采用美国巴德公司的聚丙烯疝环充填物及成型补片，对168例腹股沟疝病人进行无张力修补治疗，对手术时间、伤口疼痛、术后自主能力的恢复、住院时间、并发症及复发率等进行观察。结果 与传统疝修补手术相比，具有方法简便，术后疼痛轻，恢复快，住院时间短，并发症少，复发率低和更宽的手术指征等优点。结论 疝环充填式无张力疝修补术是一种治疗腹股沟疝的理想手术方法。     

无张力修补腹股沟疝52例报告

疝修补术是普外科最常见的手术之一，临床上运用较多的腹股沟疝修补术有ichtenstein修补术、疝环充填式无张力疝修补术、PHS修补术、腹腔镜疝修补术等。张力疝修补技术已成为目前手术治疗成人腹股沟疝的首选方法。我院自2006年至2007年用华利普疝修补装置行无张力疝修补术52例，取得了满意的效果。现报告如下。     

疝环充填式无张力疝修补术的护理

疝环充填式无张力疝修补术(flug mesh herinia repair，PMHR)是近年来治疗腹股沟疝的一种新术式。1993年开始在欧美、日本等国家广泛开展，被称为腹外疝手术的新概念和腹外疝治疗新的里程碑。我国1997年引进此术式。我科自2000年1月至2003年5月对129例腹股沟疝患者施行了疝环充填式无张力疝修补术，现将护理体会总结如下。     

平片式无张力疝修补术治疗腹股沟疝气临床应用体会

目的：分析并比较疝环填充式和平片式无张力疝修补术治疗腹股沟疝的临疗疗效。方法选择2010年1月~2013年6月于我院普外科住院治疗的腹股沟疝患者98例，随机分为观察组和对照组，每组各49例。观察组采用平片式无张力疝修补术治疗，对照组采用疝环充填式无张力疝修补术治疗。结果观察组的临床总有效率明显高于对照组(P<0.05)。观察组手术时间和术中出血量均明显少于对照组(P<0.05)。观察组住院时间明显短于对照组，治疗总费用亦明显少于对照组(P<0.05)。观察组并发症发生率明显低于对照组(P<0.05)。结论平片式无张力疝修补术治疗腹股沟疝临床疗效明显优于疝环填充式无张力疝修补术，其术式简单、痛苦小、恢复快、并发症少、复发率低，值得在临床推广应用。     

疝环充填式无张力疝修补术在老年腹股沟疝中的应用

目的评价疝环充填式无张力疝修补术应用于老年腹股沟疝的临床效果。方法对2002年1月至2006年12月收治的68例老年腹股沟患者的临床资料进行回顾性分析。结果全部病例治愈，平均手术时间50min，平均住院5．6d，并发症发生率11．8％（8／68）。随访6～66月，无术后复发。结论疝环充填式无张力疝修补术是一种完全符合生理解剖特点的手术方式。具有操作简单、创伤小、恢复快、复发率低及适应证广等优点，适合于老年患者。     

门诊局麻疝环充填式无张力疝修补术42例报告

目的：探讨门诊局麻疝环充填式无张力疝修补术可行性和安全性。方法2010年03月~2013年01月,在门诊局麻下采用疝环充填式无张力疝修补术,完成单侧腹股沟疝修补术42例。其中斜疝41例(复发斜疝l例),直疝1例。结果42例均顺利完成手术,麻醉效果满意。手术时间20~65 min,平均32 min。在院时间3~20 h,平均4.8 h。42例随访2~24个月,平均9.5月,无复发和睾丸萎缩。结论门诊局麻下疝环充填式无张力疝修补术安全可靠,经济方便,适合Ⅱ~Ⅲ型单侧腹股沟疝患者。     

二次内环重建全腹股沟疝修补术的临床应用

目的：探讨二次内环重建全腹股沟疝修补的临床效果。方法：回顾分析2007年1月～2010年1月收治的120例非嵌顿和绞窄型的腹股沟疝患者的临床资料。75例行二次内环重建全腹股沟疝修补的患者为二次内环重建组,45例行疝环充填式修补的患者为Plug—mesh组。对比2组患者术中情况、术后并发症以及恢复情况。结果：两组在平均手术时间、阴囊血肿、切口下积血／液、局部异物感、每例补片材料消耗及复发例数方面比较,差异有统计学意义（P〈0．05）;术后疼痛感方面Plug—mesh组总体明显高于二次内环重建组（P=0．001）;两组患者在平均下床活动时间、平均住院时间、切口裂开及感染、瘘道形成方面比较,差异均无统计学意义（P〉0．05）。术后随访1—4a,二次内环重建组无复发。结论：二次内环重建能完全修补全腹股沟疝,从应用生物力学理论和应用方法学上,符合全腹股沟肌耻骨孔疝修补。     

Danish Hernia Database recommendations for the management of inguinal and femoral hernia in adults

The nationwide Danish Hernia Database, recording more than 10,000 inguinal and 400 femoral hernia repairs annually, provides a unique opportunity to present valid recommendations in the management of Danish patients with groin hernia. The cumulated data have been discussed at biannual meetings and guidelines have been approved by the Danish Surgical Society. Diagnosis of groin hernia is based on clinical examination. Ultrasonography, CT or MRI are rarely needed, while herniography is not recommended. In patients with indicative symptoms of hernia, but no detectable hernia, diagnostic laparoscopy may be an option. Once diagnosed, hernia repair is recommended in the presence of symptoms affecting daily life. In male patients with minimal or absent symptoms watchful waiting is recommended. In females, however, repair is recommended also in asymptomatic patients. In male patients with primary unilateral or bilateral groin hernia the preferred method is mesh repair, either at open surgery (Lichtenstein) or laparoscopically, irrespective of age. Conventional tension-producing methods like Bassini, McVay or Shouldice are no longer recommended in a routine elective setting. Whether repair should be done by open or laparoscopic technique, depends on local expertise, economical considerations and patient preference. Compared to the Lichtenstein operation laparoscopic repair is associated with less acute pain and faster recovery. Furthermore, available data suggest less chronic long-term pain after laparoscopic repair. In female patients laparoscopic repair is the recommended method. In patients with recurrent hernia laparoscopic repair is preferred in patients with a previous open repair, while patients with recurrence after laparoscopic repair should undergo open mesh repair. In open repair it is recommended to use a mesh secured with a nonabsorbable monofilament suture. In laparoscopic repair a mesh without a slit and with a minimum size of 15 by 10 cm is used. For mesh fixation absorbable or nonabsorbable tacks or glue can be used. Elective surgery for groin hernia should be performed in an outpatient setting, using cost-effective local anaesthesia in open mesh repair and general anaesthesia for laparoscopic repair. Spinal anaesthesia is not recommended. Routine prophylactic antibiotics are not indicated. In the early convalescence period there are no physical restrictions. These guidelines will also be available at the website for the Danish Hernia Database (www.herniedatabasen.dk). The guidelines will be updated when new substantial evidence becomes available.     

Modified kugel补片疝环充填式无张力疝修补的生物相容性

BACKGROUND: Mesh plug tension-free hernioplasty is commonly used for inguinal hernia. In the operation, different mesh materials can be selected, among which the modified Kugel mesh is extensively applied.     

单丝聚酯疝补片应用于腹股沟疝修补术的临床研究

目的 研究单丝聚酯疝补片用于腹股沟疝修补的安全性及有效性.方法 选取行单侧腹股沟疝修补术的30例患者,分为试验组采用聚酯补片,对照组使用聚丙烯补片.比较两组疗效、产品安全性和不良反应事件.结果 基线资料差异均无统计学意义(P>0.05).术后随访1～6个月,两组间均无复发.术后异物感评分和第三个月随访异物感评分差异有统...     

无张力疝修补术在腹股沟斜疝治疗中的应用体会

目的总结疝环充填式无张力疝修补术治疗腹股沟斜疝的经验，探讨手术要点和注意事项。方法回顾分析112例疝环充填式无张力疝修补术治疗腹股沟斜疝的临床资料。结果112例均顺利完成手术，手术时间30～60min，平均40min；95％以上的患者在术后8～12h即可下床活动；无明显并发症发生，随访12～24个月，没有复发病例。结论疝环充填式无张力斜疝修补术并发症少，是治疗腹股沟斜疝的理想术式。     

Cost effective use of mosquito net mesh in inguinal hernia repair

Mesh hernia repair is one of the commonest open techniques of inguinal hernia repair. The main limiting factor in the use of new meshes is the cost. We carried out a prospective randomized double blind study and comprising of a hundred patients with 100 inguinal hernias admitted consecutively for elective surgery, divided into the polypropylene mesh (PPM) group and the mosquito net mesh (MNM) group each containing fifty patients. All cases were completed successfully and results revealed no difference in two groups. The results of the present study, in consistent with the published literature, reveal that the cheap indigenous mosquito mesh, which has similar properties of an imported mesh, can be safely used for tension-free inguinal hernia repair in adults. Further trials with a larger number of patients and longer follow-ups are justified and recommended.     

Materials characterization of explanted polypropylene hernia meshes

Hernia repair with prosthetic mesh significantly decreases the rate of recurrence compared with traditional, primary suture repair by reducing the tension on the edges of the wound. However, there are several complications associated with the use of mesh that may be due to the chronic inflammatory reaction to the mesh or a loss of compliance after degradation of the material. Mesh contraction and migration can also occur, sometimes resulting in a recurrent hernia. Based on the chemical structure of the polypropylene mesh material and the physiological conditions to which it is subjected, it is possible that oxidation is responsible for these changes in material properties. Oxidation would result in surface cracking, decreased melting temperature, loss of mass, and reduced compliance of the material. The objective of this study was to identify physiochemical changes in the surface and bulk properties of explanted polypropylene hernia meshes compared to pristine polypropylene mesh materials. Several characterization techniques were utilized, including scanning electron microscopy, differential scanning calorimetry, thermogravimetric analysis, and compliance testing. Overall, the results supported our hypothesis that oxidation is involved with the degradation of polypropylene hernia mesh materials.