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1.
Three patients who presented with scrotal swelling within a few days of inguinal herniorrhaphy are reported. Ultrasonography scans performed in these patients all demonstrated features suspicious of recurrence of hernia. One patient underwent surgical exploration, which revealed only a scrotal haematoma without evidence of recurrent hernia. The other two patients were managed conservatively because clinically the swellings were regarded to be more compatible with haematoma. Both patients had subsequent resolution of the scrotal swelling with no clinical evidence of recurrence of hernia on follow‐up. It is concluded that sonographic diagnosis of recurrence of hernia shortly after inguinal herniorrhaphy can occasionally be misleading. 相似文献
2.
A 22-year-old man who had previously undergone work-up for right cryptorchidism and been diagnosed as having right testicular absence was referred for repair of a right inguinal hernia. A laparoscopic approach was chosen for this patient, and at the time of laparoscopic herniorrhaphy, a small intraabdominal testicle was visualized and removed laparoscopically.Laparoscopy has served as an excellent procedure for locating intraabdominal testes and planning the most appropriate treatment for many cryptorchid patients. Until recently, atrophic testes located within the abdominal cavity through use of a laparoscope were removed via an open technique. Advances in laparoscopy now enable detection and definitive treatment for these patients without the need for large, more painful incisions.The laparoscopic approach to this patient enabled diagnosis and management of his cryptorchidism and provided a means for repair of his hernia. 相似文献
3.
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 相似文献
4.
Carroll J. Bellis 《ANZ journal of surgery》1994,64(5):295-296
Laparoscopic inguinal herniorrhaphy with or without application of mesh does not correct the basic problem. Unless the dense fascial and bony margins of the posterior inguinal canal wall are palpated under direct vision for suture of the mesh, fortification is not possible and recurrence is invited. The many neural structures cannot be seen with the laparoscope, and their stapling is a prominent hazard. The procedure should not be accepted or approved. 相似文献
5.
徐万里 《中国医师进修杂志》2004,27(14):23-25
目的 对比评价电视腹腔镜腹股沟疝修补术和切开法填充式无张力疝修补术的临床疗效。方法 对 12 0例腹股疝患者进行随机分组 ,其中 6 2例实施腹腔镜下疝修补术 ,5 8例实施切开法无张力疝修补术 ,比较两组的手术时间、术后疼痛持续时间、术后并发症发生率 (伤口出血、感染、尿潴留、阴囊水肿等 )、出院时间、复发率、切口美观指数。结果 腹腔镜组除手术时间长于切开法组外 ,其余各指标均优于切开法组 ,具有显著的统计学意义。结论 腹腔镜下行腹股沟疝修补术较之切开法无张力疝修补术确实有术后疼痛轻、下床活动早、住院时间短、恢复快、切口美观和并发症少等较多优点 ,为腹股沟疝的治疗提供更多更优良的选择方法。 相似文献
6.
目的对比分析局麻与硬外麻醉下无张力修补术治疗腹股沟疝疗效,探讨基层医院在有限条件下治疗腹股沟疝更适宜的麻醉方式。方法采用前瞻性研究方法,纳入研究的患者为2016年7月至2017年1月半年来收治的102例腹股沟疝所有患者分成局麻组与硬外麻组,两组均采用疝囊高位结扎+平片无张力修补术,比较两组手术时间、术后伤口疼痛时间、术后不良反应和并发症的发生和差异;记录术后患者对麻醉效果的满意度;出院后嘱病人1周后回院复查1次,1个月、6个月、12个月、24个月电话随访1次。结果两组皮下血肿、术后伤口感染、阴囊肿胀、腹股沟神经与腹腔脏器损伤、术后伤口疼痛时间差异无统计学意义(P0.05),局麻组住院时间、住院费用、恶心/呕吐、头昏/头痛、尿潴留并发症发生率均比硬外麻组低或少,两组差异有统计学意义(P0.05)。两组患者在2年随访中各有2例出现腹股沟区疼痛,服用NSAIDs类药物好转。两组术后1月、6月、12月和24月VAS评分结果,其差异没有统计学意义(表3)。两组患者对手术中麻醉满意情况见表4,硬膜外组满意患者多于局麻组。结论基层医院实施局麻下开放式腹股沟疝平片无张力修补术可行,也不增加慢性疼痛的发生。 相似文献
7.
目的探讨传统疝修补术与无张力疝修补术后慢性疼痛的原因及治疗。方法对我院自2002年2月至2010年9月426例实施传统疝修补术与无张力疝修补术患者的临床资料进行回顾性地分析。结果所有患者根据手术方式分为两组:传统疝修补术组(n=210)和无张力疝修补术组(n=216)。术后疼痛发生率,传统疝修补术组为9.0%(19/210),无张力疝修补术组为4.2%(9/216),两者差异有统计学意义(P〈0.05)。结论聚丙烯平片无张力疝修补术可减少腹股沟疝修补术后慢性疼痛的发生,传统疝修补术与无张力疝修补术后慢性疼痛引起的原因不同治疗方法基本相同。 相似文献
8.
复发是腹股沟疝修补术后常见的并发症之一,引起腹股沟疝修补术后复发的原因包括病人自身的因素和医源性因素,其中部分因素可通过临床干预而改变。重视对腹股沟疝修补术后病人宣教和管理随访,尤其是治疗引起的腹内压增高相关疾病;加强外科医师的系统学习和技术培训,提高理论和技术水平,规范手术准入制度,强调手术质量控制;根据病人的具体情况和术者的技术经验选择合适的手术方式;术中游离充足的空隙并选择相匹配大小的补片,严格遵守无菌操作和确切止血,减少术后发生感染和出血。采取上述措施可有效减少腹股沟疝术后复发的危险因素。 相似文献
9.
10.
Fernando Spencer Netto Fayez Quereshy Bruna G. Camilotti Kristen Pitzul Josephine Kwong Timothy Jackson Todd Penner Allan Okrainec 《JSLS, Journal of the Society of Laparoendoscopic Surgeons》2014,18(4)