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21.
目的:探讨腹腔镜在腹股沟疝修补手术中的优缺点,方法:31例腹股沟疝行腹腔镜疝修补术,其中斜疝25例,直疝6例,复发疝4例,均行腹腔内术式(TAPP)。结果:手术全部完成,平均手术时间61min(40-95min),无中转手术,4例同时行胆囊切除术,平均住院7.5d,术后近期随访无复发,结论:腹腔镜疝修补术是一种安全的手术,术后恢复时间短,复发率低。 相似文献
22.
Antonio S. Salinas Sánchez Jesús Cifuentes Tebar Miguel Segura Martín José M. Giménez Bachs María J. Donate Moreno Héctor Pastor Navarro Julio A. Virseda Rodríguez 《American journal of transplantation》2005,5(8):2074-2077
Ureteral herniation is a rare entity. We report the first case of extraperitoneal ureteral herniation in a pediatric en bloc renal graft causing obstructive uropathy. A 70-year-old, obese patient with an en bloc renal transplant was found to have ureterohydronephrosis in the right renal graft on magnetic resonance imaging. Nephrostomy with insertion of a double-J catheter confirmed the presence of a ureteral loop within the inguinal tract. Surgery confirmed herniation of the ureter through the internal inguinal ring, crossing over the spermatic cord. We performed release, resection, ureteral reimplantation and hernioplasty. Four months later, renal function was normal and urinary tract dilation had diminished. This case illustrates an unusual cause of obstructive uropathy in a transplanted kidney. Apart from obesity, two other factors may have contributed to its development: presence of a redundant ureter, and the fact that the ureter had been placed over, rather than under, the spermatic cord. 相似文献
23.
Z. Malazgirt K. Topgul S. Sokmen S. Ersin A. G. Turkcapar H. Gok N. Gonullu M. Paksoy M. Ertem 《Hernia》2006,10(4):326-330
Most of the papers published on spigelian hernia are either case reports or small retrospective series. In this prospective
multicenter study, we aimed to outline the specific features of spigelian hernias and patients’ characteristics more clearly.
Surgeons enrolled patients to be entered into the database as they diagnosed and treated the hernias at will. The baseline
and surgical outcome parameters were noted in each patient. A painful mass was the main presenting complaint in half of 34
patients. Accurate preoperative diagnosis was possible in 31 patients. Open intraperitoneal mesh repair was the preferred
technique. The mean hospital stay and time until return to normal daily activities were 4.1 and 15.6 days. Although a rare
condition, diagnosis of a spigelian hernia is not difficult once remembered. Its surgical repair seems to cause few complications
and is very well tolerated by the patient. 相似文献
24.
This study presents the case of a patient with necrobiosis or necrosing fascitis of the inguinal region, secondary to a complicated
Amyand’s hernia with a concomitant ipsilateral Richter’s hernia. The patient was treated with open trans-abdominal surgery
and hernia repair through the pre-peritoneal approach, plus anti-microbians, and thrice-daily wound cleansing and dressings
to the inguinal region. Evolution was satisfactory. There are no reports in the literature of a case such as this. 相似文献
25.
硬膜外穿刺针外套管在腹腔镜小儿斜疝高位结扎术中的应用 总被引:3,自引:0,他引:3
目的探讨硬膜外穿刺针外套管在腹腔镜小儿斜疝疝囊高位结扎中的应用价值。方法2003年4月-2006年5月,我院对230例小儿斜疝手术应用硬膜外穿刺针外套管代替雪橇钩针实施腹腔镜疝内环口荷包高位结扎术。结果230例手术均获得成功,手术时间:单侧161例8-10 min,嵌顿疝39例15-20 min,双侧30例16-20 min;术后未见有阴囊水肿及睾血疼痛及缺血坏死。术后随访2-6个月111例,6-12个月52例,12-24个月37例,24-36个月30例,无复发。结论硬膜外刺针外套管可替代小儿疝囊结扎专用的雪橇钩针,简便,经济,适合在所有基层医院推广。 相似文献
26.
目的:探讨先天性膈疝的产前超声表现。材料和方法:回顾性分析6例先天性膈疝胎儿声像图表现特征,并与病理结果相对照。结果:左侧膈疝5例,右侧膈疝1例,其中2例伴有其它复杂畸形。超声显示胎心、纵隔受压移位,心轴偏移明显。疝入器官见有胃泡、肠管、肝脏,胎儿呼吸样运动可致疝入器官运动幅度增加。结论:先天性膈疝的特征性声像图表现,可作为诊断的重要依据。 相似文献
27.
Background The incidence rate of incisional hernias after open surgery has been reported to be higher than that of port site hernias
after laparoscopic surgery. No studies have compared the costs for the health care system in treating those two types of hernia.
Methods A systematic review was conducted to obtain the baseline data, and a decision analysis model was created to simulate the occurrence
and recurrence of incisional and port site hernias.
Results The overall risk of having incisional hernias was eight-times higher than that of having port site hernias (7.4% vs 0.9%).
A cost savings of £93 per patient can be generated for the health care system in the UK. Similar results were obtained for
Germany, Italy and France.
Conclusions The additional treatment costs for incisional hernia should be taken into account when the costs of a surgery performed by
open approach are compared with by laparoscopy. 相似文献
28.
Inguinal hernia is a known complication after radical retropubic prostatectomy (RRP). We have investigated whether other types
of lower midline incision surgery in males increase the risk of inguinal hernia. Male patients operated with open prostatectomy
for benign prostate hyperplasia (n = 95), pelvic lymph node dissection for staging of prostate cancer (n = 88), or cystectomy for bladder cancer (n = 76) were identified and were sent questionnaires in which they were asked about postoperative inguinal hernia morbidity.
Two-hundred and seventy-one men operated with RRP had previously received a similar questionnaire. The answers were compared
with those from a control group of 953 men who had not undergone surgery. Annual attributional hernia morbidity and Kaplan–Meier
hernia-free survival were calculated. The cumulative incidence of post-operative inguinal hernia and annual attributional
hernia morbidity after the respective surgical procedures were clearly higher during the early years post-operation than for
nonoperated patients. Inguinal hernia is a common postoperative complication in males after all the lower midline incision
surgery investigated. 相似文献
29.
Internal Hernias: Clinical Findings,Management, and Outcomes in 49 Nonbariatric Cases 总被引:1,自引:0,他引:1
Saber Ghiassi Scott Q. Nguyen Celia M. Divino John C. Byrn Avraham Schlager 《Journal of gastrointestinal surgery》2007,11(3):291-295
Internal hernia, the protrusion of a viscus through a peritoneal or mesenteric aperture, is a rare cause of small bowel obstruction.
We report the clinical presentation, surgical management, and outcomes of one of the largest series of nonbariatric internal
hernias. Ten-year retrospective review of patients at our institution yielded 49 cases of internal hernias. Majority of patients
presented with symptoms of acute (75%) or intermittent (22%) small bowel obstruction. While 16% of CT scans were suspicious
for internal hernia, in no cases the preoperative diagnosis of internal hernia was made. The most frequent internal hernias
were transmesenteric (57.0%) and 34 hernias (69%) were caused by previous surgery. All internal hernias were reduced and the
defects were repaired. Compromised bowel was present in 22 cases and 11 patients underwent small bowel resection. The mean
postoperative hospitalization was 10.9 days. The overall mortality rate from our series is 2%, and the morbidity rate is 12%.
Transmesenteric hernias, as complications of previous surgeries, are the most prevalent internal hernias. Preoperative diagnosis
of internal hernia is extremely difficult because of the nonspecific clinical presentation. However, if discovered promptly,
internal hernias can be repaired with acceptable morbidity and mortality.
Poster presentation at Digestive Disease Week, May 22, 2006, Los Angeles, California, USA. 相似文献
30.
Mesh fixation with human fibrin glue (Tissucol) in open tension-free inguinal hernia repair: a preliminary report 总被引:2,自引:0,他引:2
S. Canonico A. Santoriello F. Campitiello A. Fattopace A. Della Corte I. Sordelli R. Benevento 《Hernia》2005,9(4):330-333
Background: The Lichtenstein technique for inguinal hernia repair is easy to learn and associated with few complications. However, recent
studies have suggested that this technique is inferior to some ‘sutureless’ repair systems in terms of perceived difficulty,
operating time, surgeon satisfaction, etc. Methods: We employed a sutureless Lichtenstein technique in 80 consecutive patients with primary unilateral inguinal hernia, to assess
patient and trainee surgeon outcomes. Human fibrin glue was used in place of conventional sutures. Results: The mean operating time was 36 min and all patients were discharged 5–6 h after the operation. On a 100-point visual analogue
scale, the surgeons rated the difficulty of the operation as low (mean score, 31), and perceived satisfaction as high (mean
score, 84). No complications were observed at 12-month follow-up. Conclusion: This study confirms the efficacy of mesh fixation with human fibrin glue, and supports the viability of a sutureless Lichtenstein
procedure. 相似文献