疝环充填式无张力疝修补术并发症的原因及对策

目的：探讨疝环充填式无张力疝修补术并发症的发生原因和对策。方法：总结分析326例患者的临床资料。结果：术后出现局部硬块和异物感6例(1．8％)，切口及阴囊血肿或水肿7例(2．1％)，切口感染4例(1．2％)，复发3例(0．9％)．顽固性疼痛9例(2．8％)。结论：手术规范操作和正确治疗是预防并发症发生的要点。     

疝环充填式无张力疝修补围手术期的护理

疝是普通外科的常见病、多发病。由于以往手术是有张力的缝合，虽然术后护理强调卧床三天、休息三周、不参加重体力劳动三个月，但复发率仍高达10—15％。近几年来无张力疝修补术已成为国际上疝修补手术的发展新趋势。当前疝的住院病人中有伴发病的老年病人明显增多，这是由于老年病人腹     

疝环充填式无张力疝修补术的应用及护理

1998年 4月至 9月 ,我们选用美国进口的塞子和补片 ,为 2 5例腹股沟斜疝患者施行疝环填充式无张力疝修补术 ,效果满意 ,现将护理体会报告如下。1　资料和方法1 1　腹股沟斜疝 2 5例 ,男 2 1例 ,女4例 ,平均 5 4岁 ,左侧 1 8例 ,右侧 7例 ,其中 2例疝进入阴囊。1 2　麻醉方法　均采用改良的硬膜外麻醉。1 3　填充物　填充物包括塞子和补片。塞子外型似圆锥形 ,带有竖纹 ,内有 3层 ,有许多米粒状网眼 ,底面直径约 3ｃｍ ,高约 5ｃｍ ;Ｙ型补片 ,约6ｃｍ长 ,3ｃｍ宽。用塞子填充疝的内环。Ｙ型的补片夹在精索上或子宫圆韧带上 ,起加固作…     

疝环充填式无张力疝修补术的护理

无张力疝修补术是近年来治疗腹股沟疝的一种新的手术方式。我院自2001年1月-2004年1月共施行疝环充填式无张力疝修补术56例，取得了满意的效果，现将护理体会总结如下。     

疝环充填式无张力疝修补术的临床研究

作者自1998年1月～2003年5月,将54例腹股沟疝采用疝环充填式无张力疝修补术(简称充填术)与疝传统方法修补术的50例进行对比研究,总结如下.     

疝环充填式无张力疝修补63例临床分析

目的：探索疝环充填式无张力疝修补术的方法及临床应用。方法：本组共收治腹外疝63例，其中男性61例，女性2例。平均年龄65．6岁。局麻或硬膜外麻醉。结果：术后数小时即可下床活动，疼痛轻，无手术死亡。术后8例出现尿潴留，其余手术并发症均未发现。随访1个月～2年，尚无1例复发。结论：本术式较传统的疝修补操作简单，手术效果满意，复发率低，是疝修补术的新趋势^[1]。     

腹股沟疝充填式无张力疝修补手术的效果

目的:探讨腹股沟疝充填式无张力疝修补手术的效果。方法:采用回顾性、抽样总结研究方法,选择在本院诊治的74例腹股沟疝患者,所有患者都给予充填式无张力疝修补手术,记录与随访所有患者的预后。结果:所有患者都顺利完成手术,无术中并发症发生。术后发生切口血肿3例,疼痛5例,并发症发生率为10.81%,所有并发症经过对症处理后好转。所有患者术后随访1年,复发2例,复发率为2.70%。结论:腹股沟疝充填式无张力疝修补手术是一种安全有效的方法,复发率、并发症发生率低,有很好的应用价值。     

疝环充填式无张力疝修补术的护理

近几年来无张力疝修补术已成为国际上疝修补手术的发展新趋势，该手术具有创伤小、恢复快、并发症少等优点，尤对老年患者，较大地减轻痛苦，降低复发率，符合社会老龄化的要求。“疝环充填式无张力疝修补术”是以一个Bard补片为原料的锥形物填充在疝环内、另一平片置于精     

传统疝修补术与疝环充填式无张力疝修补术在腹股沟疝治疗中的应用体会

目的比较传统疝修补术与疝环充填式无张力疝修补术在腹股沟疝治疗中临床疗效。方法选取2006年2月至2010年12月期间住院的120例腹股沟疝患者,随机分为两组,对照组40例:采用传统修补术,治疗组80例:使用疝环充填式无张力修补术。对比分析两组手术时间、下床时间、住院时间、术后并发症和复发等情况。结果治疗组在下床活动时间、住院时间、术后并发症和复发率方面均优于对照组,差异具有统计学意义(P<0.01),在手术时间上无明显统计学差异(P>0.05)。结论疝环充填式无张力疝修补术具有住院时间短、创伤小、痛苦小、术后恢复快、伤口无感染、成功率较高、复发率低等优点,符合腹股沟解剖和生理结构,为目前腹股沟疝手术治疗的首选术式。     

疝环充填式无张力疝修补术治疗腹股沟疝

目的探讨聚丙烯网塞及补片在腹股沟疝修补术中的优点、并总结经验教训。方法采用美国巴德公司的聚丙烯锥形填充物及成型补片对216例腹股沟疝病人施行疝环填式无张力疝修补术,观察手术时间,伤口疼痛,术后自主能力恢复,并发症及复发率。结果手术时间平均为45min;术后3～8h病人能下床活动;伤口疼痛时间2～3d。术后排尿困难3例,切口血肿1例,无一例切口感染。腹股沟异物感10例,睾丸炎1例。术后随访6～96月206例,仅1例复发,复发率0．45％。结论锥形填充物及成型补片组织兼容性好,无排异反应,具有一定的抗感染能力,是理想的疝修补材料。疝环填充式无张力修补术,手术操作简便,损伤轻,恢复快,并发症少和复发率低,手术指征可适当放宽,是较先进的疝修补术式。     

Laparoscopic mesh repair for lumbar hernia after iliac crest bone harvest

Lumbar hernia after iliac crest bone harvest is relatively rare. When it does occur, it presents as a flank abdominal protrusion through a lateroposterior abdominal wall defect. A laparoscopic approach for this type of hernia is reported to have advantages over the classic open method. Here, we present a case of a 49‐year‐old Caucasian man who presented with an enlarged left flank mass after iliac bone harvest for pseudarthrosis. He had undergone open onlay mesh repair for inferior lumbar hernia, but the hernia recurred 3 months postoperatively. Laparoscopic intraperitoneal onlay mesh repair using a composite mesh was performed 7 months after recurrence. The patient was discharged 6 days postoperatively without complications. No signs of recurrence were detected during 1‐year follow‐up period. The laparoscopic approach for lumbar hernia conferred excellent visualization of the hernia defect and enabled a safe mesh repair using intra‐abdominal pressure to hold it in position. This approach provided all the benefits of minimally invasive surgery.     

Abdominal wall hernia mesh repair: sonography of mesh and common complications.

OBJECTIVE: The purposes of this study were (1) to review the sonographic in vitro and in vivo appearances of mesh for surgical repair of abdominal wall hernias, (2) to describe sonographic techniques and discuss the limitations of sonography in evaluation of mesh hernia repair, and (3) to illustrate common complications after mesh repair shown with sonography. METHODS: We identified interesting cases from the musculoskeletal sonographic database as well as from the teaching files of the authors, with surgical or other cross-sectional imaging corroboration. RESULTS: A compilation of the sonographic appearances of mesh used for anterior abdominal wall and inguinal hernia repair and complications diagnosable by sonography is presented. CONCLUSIONS: Sonography can be effective for evaluation of mesh and complications after mesh repair of anterior abdominal wall and inguinal hernias.     

Chronic pain after open inguinal hernia repair

Following the widespread use of mesh repairs, recurrence rates after inguinal hernia surgery have become acceptable and focus has shifted from recurrence to chronic pain. Although pain can be controlled with analgesics, chronic postsurgical pain is a major clinical problem, which can significantly influence the patient’s quality of life. The rate of chronic pain after inguinal hernia mesh repair can reach 51.6%. The reasons for posthernioplasty chronic pain are often unclear. It has been linked to nerve injury and nerve entrapment, but there is also association between the rate of chronic pain and the type of mesh used for hernia repair. As there are >160 meshes available in the market, it is difficult to choose a mesh whose usage would result in the best outcome. Different mesh characteristics have been studied, among them weight of mesh has probably gained the most attention. The choice of adequate therapy for chronic groin pain after inguinal hernia repair is controversial. The European Hernia Society recommends that a multidisciplinary approach at a pain clinic should be considered for the treatment of chronic postoperative pain. Although surgical treatment of chronic posthernioplasty pain is limited because of the lack of relevant research data, resection of entrapped nerves, mesh removal in the case of mesh related pain or removal of fixation sutures can be beneficial for the patient with severe pain after inguinal hernia surgery. One drawback of published studies is the lack of consensus over definition of chronic pain, which makes it complicated to compare the results of different studies and to conduct meta-analyses and systematic reviews. Therefore, a uniform definition of chronic pain and its best assessment methods should be developed in order to conduct top quality multicenter randomized trials. Further research to develop meshes with optimal parameters is of vital importance and should be encouraged.     

应用疝环充填式无张力疝修补术治疗腹股沟疝

目的 探讨疝环充填式无张力疝修补术治疗腹股沟疝的特点。方法 采用美国巴德（Bard）公司生产的PerFixplug产品，治疗56例腹股沟疝，观察手术时间、切口疼痛、活动能力恢复、并发症和复发率。结果 手术时间：平均50min，切口无明显疼痛，术后下床活动时间：单侧疝平均3～10h；双侧疝平均24h。2周恢复正常工作。并发症主要是尿潴留5例，伤口积液1例，无切口感染；随访2～32个月，无一例复发。结论 疝环充填式无张力疝修补术操作简单，损伤少，恢复快，复发率低，适用范围广，是理想有效的疝修补术。     

疝环充填式无张力疝修补术治疗腹股沟疝

目的探讨聚丙烯网塞及补片在腹股沟疝修补术中的优点,以及在基层医院推广的可行性。方法采用美国巴德公司的聚丙烯锥形充填物及成型补片对40例腹股沟疝患者施行疝环充填式无张力疝修补术,观察手术时间、切口疼痛、术后自主能力的恢复、并发症及复发率：结果手术时间平均46min;术后6h后患者能下床活动;伤口疼痛时间2～3d;术后出现排尿困难1例;无复发病例。结论锥形充填物及成型补片组织兼容性好,无排异反应,有一定的抗感染能力,是理想的疝修补材料;疝环充填式无张力修补术手术操作简便,损伤小．恢复快,并发症少,复发率低,适合在基层医院推广;材料价格过高是阻碍其在基层推广的主要因素。     

疝环充填式无张力修补术在腹股沟嵌顿疝的应用

目的 讨论疝环充填式无张力修补术在腹股沟嵌顿疝的应用效果。方法 将巴德公司生产的Bard—mesh prefix plug定型产品应用于59例成人腹股沟嵌顿疝病人，其中腹股沟斜疝56例，股疝3例，平均年龄58岁，大于60岁有45例。结果 有12例合并小肠网膜坏死，行小肠网膜切除，同期采用疝环充填式无张力修补术一期修复。56例患者于术后1～2天下床活动，切口一期愈合。1例局部切口感染经换药伤口二期愈合，未出现排异反应。2例合并呼吸功能衰竭，混合性肝硬化、肝功能失代偿而死亡。结论 疝环充填式无张力修补术在腹股沟嵌顿疝的应用效果满意，对于合并肠绞窄坏死的如局部无污染同期采用疝环充填式无张力修补术一期修复，并不是绝对禁忌症。     

Laparoscopic mesh repair of parahiatal hernia: A case report

We report a case of a primary parahiatal hernia that was repaired laparoscopically with a composite mesh. A 51‐year‐old woman presented with vomiting and epigastric pain. CT scan showed a giant paraesophageal hernia with intrathoracic gastric volvulus. Intraoperatively, a diaphragmatic muscular defect was found lateral to an attenuated left crus of the diaphragm, distinct from the normal esophageal hiatus. The defect ring was fibrotic, making a tension‐free primary repair difficult. A laparoscopic mesh repair was performed with a composite mesh, which was covered with the hernia sac to prevent potential erosion into the esophagus or stomach. Recovery was uneventful and the patient was discharged on the 5 days postoperatively. She remained asymptomatic at subsequent follow‐up. Laparoscopic repair of parahiatal hernia can be safely performed. In circumstances where a large or fibrotic defect prevents a tension‐free primary repair, the use of a composite mesh can provide effective repair of the hernia.