腹股沟疝无张力修补术后复发原因及再手术方法探讨（附108例报告）

目的讨论无张力疝修补术后腹股沟疝复发原因及再次手术方法。方法对2003年4月至2008年3月间收治的108例无张力疝修补术后腹股沟复发疝患者的资料进行回顾性分析。结果原修补部位复发73例，其中平片过小34例，网塞或补片移位19例，平片变形、卷曲14例，补片位置放置错误6例。在修补部位以外（术中遗漏疝miss hernia）复发35例，其中遗漏直疝16例，股疝11例，斜疝8例。再次手术均应用腹膜前间隙修补，采用PHS及Kugel补片，术后随访1个月～5年均未复发。结论无张力修补术后腹股沟疝复发与患者术中遗留疝、补片移位、补片大小及手术方式选择不当等因素相关；选择腹膜前间隙修补是治疗无张力疝修补术后腹股沟疝复发的有效方式。

Clinical study on the causes of recurrence of inguinal hernia after tension-free hernioplasty and methods of reoperation: a report of 108 cases

Objective To investigate the causes of recurrence of inguinal hernia after tension-free hernioplasty and study the reoperative methods.Mothods The 108 cases between 2003 and 2008 of recurrent inguinal hernia after tension-free hemioplasty were studied and analyzed retrospectively.Results 73 cases recurred in primary operative position,including 34 cases of justominor mesh,19 cases of displaced patch or mesh,14 cases of deformation or curling mesh and 6 cases Patch or mesh at the wrong position.35 cases (miss hernia)recurred outside primary operative position,including 16 cases of missing direct hernia, 11 cases of femoral hernia, 8 cases of indirect hernia. Kugel and Prolene-polypropylene hernia system(PHS)was conducted for 108 cases. No postoperative recurrence was found after 1 month to 5 years followed-up.Conclusions Many factors can cause inguinal hernia to recur after tension-free hernioplasty,such as miss hernia, displaced patch or mesh, inappropriate choice of size of mesh and operation method et al. Stoppa operation is an effective way for the treatment of recurrence of inguinal hernia after tension -free hernioplasty.