Obturator hernias — Report of seven cases

Summary Obturator hernias comprise a rare group of abdominal hernias. They are often diagnosed when the small bowel has become obstructed and the patients are operated on without the causes of the obstruction being known. Although many techniques for closure of the defect are available, there is no agreement at the present time as to which is the procedure of choice.     

影响急性外份性硬脑膜外血肿疗效的相关因素分析（附484例报告）

目的探讨影响急性外伤性硬脑膜外血肿疗效的相关因素。方法对1994年5月至2004年5月收治的484例外伤性硬脑膜外血肿患者的临床资料进行回顾性分析。结果无脑疝症状者手术死亡率7.7%,有脑疝症状者死亡率21.3%。手术距脑疝发生时间<1h死亡率8.2%,1～2h死亡率40.0%,>2h死亡率72.2%。结论影响外伤性硬脑膜外血肿疗效的相关因素较多,除脑疝形成及手术距脑疝发生的时间外,创伤性低血压、合并脑损伤的程度、呼吸功能不全、大面积脑梗塞、血糖与血浆渗透压升高及肝功能异常等均对患者预后有重要影响。     

Parapubic hernia: case report and review of the literature

Parapubic hernia is considered rare, with 18 hernias described in five articles published since 1971. The hernia results from iatrogenically or traumatically detached rectus abdominis muscles at the pubic bone and presents a therapeutic challenge because there is no strong aponeurotic anchoring structure in the defect's caudal aspect. We describe a patient with a large parapubic hernia repaired by a combined preperitoneal and onlay prosthetic method. This report adds another dimension to the prosthetic repair options in parapubic hernias and illustrates the effectiveness of the tension-free repair principle in their definitive management. Electronic Publication     

高频超声在小儿腹股沟斜疝手术治疗中的价值

目的　探讨高频超声检测小儿腹股沟斜疝腹股沟管扩张程度对于选择手术方式的价值。　方法　回顾分析 4 88例施行单纯疝囊高位结扎手术的小儿腹股沟斜疝超声检测的腹股沟管扩张最大内径 ,分组追踪其术后斜疝复发率。　结果　腹股沟管扩张最大内径 >1.5 cm的一组病例术后复发率明显增高。　结论　高频超声检测腹股沟管扩张最大内径 >1.5 cm的小儿腹股沟斜疝有必要行斜疝修补术 ,减少复发率 ,为临床医师提供有价值的客观指标     

Femoral pseudo-hernias

Before surgical intervention in the femoral area, doctors should be mindful of two situations in which surgery is not indicated and, in fact, may cause harm. Electronic Publication     

Laparoscopic repair of a diaphragmatic hernia through the foramen of Morgagni

A 78-year-old woman is described who presented with a diaphragmatic hernia through the foramen of Morgagni. A definitive diagnosis was confirmed by a sagittal view on magnetic resonance imaging prior to surgery. The hernia was repaired laparoscopically under an abdominal wall lifting technique without pneumoperitoneum, and her symptoms completely resolved postoperatively with no evidence of recurrence. The laparoscopic repair was considered a suitable and safe procedure for the treatment of a Morgagni hernia. Received: 3 April 1996/Accepted: 3 May 1996     

The role of the endoscopic extraperitoneal approach in large inguinal scrotal hernias

The role of endoscopic extraperitoneal herniorrhaphy (EEPH) in the management of giant scrotal hernias has not been well defined, and the technical details relating to operations on such hernias have not been described. We present our experience with 17 patients undergoing repair of giant scrotal hernias. Foley catheter bladder decompression was routinely employed. The Retzius space was developed early in the procedure and hernia sac contents were reduced in all cases. The inferior epigastric vessels were likewise divided in all patients. The average operative time was 76 min and all patients were discharged home the same day. There have been no recurrences on follow-up. There was no mortality, and morbidity was limited to seroma formation in two patients. We conclude that with certain technical modifications, EEPH can be safely employed for the treatment of giant scrotal hernias. Received: 7 May 1996/Accepted: 12 July 1996     

Laparoscopic treatment of giant paraoesophageal hernias

Summary The authors report their experience of laparoscopic repair of large paraoesophageal hernias (POH). From February 1994 to January 1997, nine patients with a large POH containing at least 50% of the stomach have been treated laparoscopically. The surgical procedure included reduction of the herniated stomach, closure of the hiatal orifice, and construction of a circular fundoplication. There was no conversion into open surgery. One case of postoperative atelectasis was seen (morbidity: 12.5%). Postoperative X-Ray demonstrated the restoration of a normal anatomical arrangements as well as an effective anti-reflux fundoplication. Laparoscopy makes it possible to safely and efficiently repair large POHs with an acceptable morbidity. However, this type of operation requires a good training in laparoscopic surgery.     

撑开式椎板成形术治疗伴有马尾神经损害的腰椎间盘突出症

目的总结分析伴有马尾神经损害的腰椎间盘突出症的临床特点,并对手术方法进行探讨.方法对采用撑开式椎板成形术治疗的26例伴有马尾神经损害的腰椎间盘突出症患者的临床资料进行回顾性分析.结果获得随访资料26例平均随访6年5个月,根据Macnab疗效标准,优17例,良7例,可1例,差1例.优良率92.3%.结论伴有马尾神经损害的腰椎间盘突出症的临床症状重,手术治疗需要彻底减压方能取得优良效果.采用撑开式椎板成形术显露,除具有全椎板切除的优点,还不破坏腰椎后柱的稳定性,最大限度地保留了脊柱的完整性,减小了手术创伤,是行之有效的手术方法.     

Iatrogenic diaphragmatic hernia due to laparoscopic gastric banding

A patient developed a huge diaphragmatic hernia following laparoscopic gastric banding. Almost the entire stomach was incarcerated within the left chest. Segmental necrosis of the greater curvature of the stomach necessitated partial gastrectomy. The postoperative course was uneventful. The etiology, diagnosis and treatment of this previously undescribed complication of laparoscopic gastric banding are addressed in relation to the present case.