加强腹横筋膜在Ⅲ型腹股沟疝无张力修补术中的作用研究 |
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引用本文: | 杨毅军,林龙,邱庆安,王保春.加强腹横筋膜在Ⅲ型腹股沟疝无张力修补术中的作用研究[J].中华疝和腹壁外科杂志(电子版),2009,3(4):23-26. |
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作者姓名: | 杨毅军 林龙 邱庆安 王保春 |
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作者单位: | 海南省人民医院暨海南医学院附属人民医院普通外科,海口,570311 |
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摘 要: | 目的探讨加强腹横筋膜在Ⅲ型腹股沟疝无张力修补术中的作用和价值。方法回顾性分析2005年1月至2006年12月的135例腹股沟疝患者的临床资料。第一组65例采用Millikan技术或应用双层普理灵补片加强腹横筋膜,第二组70例采用经典的疝环充填式无张力修补术。结果两组病例在性别比例、平均年龄、合并疾病等方面相似,具有可比性。两组的平均手术时间分别为49min、41min,术后平均住院天数分别为5.4d、5.1d,均无显著差异。两组总体并发症发生率分别为12.3%(8/65)、15.7%(11/70),无明显差异,但第一组术后慢性疼痛发生率(1.5%)明显低于第二组(7.1%)。随访24个月以上,第一组无复发病例,第二组复发率为4.3%(3/70),两组差异有显著性意义。结论在腹股沟疝无张力修补术中注重腹横筋膜的加强,可以有效地提高疗效、减少并发症。
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关 键 词: | 疝 腹股沟 外科手术 无张力疝修补 腹横筋膜 |
Study of the efficacy of transversalic fascia reinforcement in tension-free herniorrhaphy of Type Ⅲ inguinal hernias |
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Authors: | YANG Yi-jun LIN Long QIU Qing-an WANG Bao-chun |
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Institution: | (Department of General Surgery, Hainan Provincial People's Hospital,Haikou 570311, China) |
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Abstract: | Objective To evaluate the clinical efficacy of transversalic fascia reinforcement in tension-free herniorrhaphy of Type Ⅲ ( Chinese Classification ) inguinal hernias. Methods The clinical data of 135 cases with inguinal hernias received tension-free hernioplasty in our hospital from Jan. 2005 to Dec. 2006 were retrospectively analyzed. Group 1 ( n = 65) : the Millikan' s modified technique or Prolene Hernia System (PHS) was adopted in order to reinforce the transversalic fascia. Group 2 ( n = 70 ) : conven- tional Mesh Plug & Patch was used. Results There was no significant difference between two group in gender, mean age and combined diseases. The mean operating time of group 1 was 49 min, and that in group 2 was 41 min. The mean postoperative hospital stay was 5.4 days (group 1 ) and 5.1 days ( group 2) respec- tively. There were no significant difference . The common complication rate was 12.3 % (8/65) and 15.7 % (11/70) respectively in the two groups without significant difference, but the postoperative chronic pain in group 1 ( 1.5 % ) was significant lower than that in group 2 (7.1% ). All patients were followed-up over 24 months. The recurrence rate in group 1 (0) was notablely lower than that in group 2 (4.3 % ). Conclusions In tension - free herniorrhaphy, paying attention to reinforce transversalic fascia can effectively improve efficacy and reduce the complications. |
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Keywords: | Hernia ingninal Tension-free herniorrhaphy Transversalic fascia |
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