Millikan术式治疗腹股沟复发疝手术体会

目的探讨用Millikan术式治疗复发性腹股沟疝的方法及效果。方法回顾分析我院普外科收治的31例腹股沟复发疝患者，均为男性，年龄38—85岁，平均年龄61．5岁。复发疝单侧29例，双侧2例，共33例次。二次复发8例，三次复发2例。复发时间距上次手术时间20d至25年。平均12．5年。第一次手术方式：传统手术31例次，其中Bassini法19例次，Halsted法8例次。方法不明4例次。二次及三次复发者均为传统疝修补方法。无张力疝修补术2例次，为3DP补片修补。合并高血压、冠心病15例，糖尿病10例，慢性阻塞性肺病6例，前列腺增生10例。结果全部病例均一期愈合，随访0．5～4年无复发。结论Millikan术式治疗复发性腹股沟疝效果良好。正确确认腹横筋膜层，充分游离腹膜前间隙，网塞正确、可靠的固定是手术成功的关键。

Clinical experience of Millikan tension-free hernioplasty in recurrent inguinal hernia

Objectiv To discuss the effects of applicating Millikan technic in recurrence inguinal hernia. Methods Data of 31 patients with recurrent inguinal hernia in our hospital were analyzed retrospec- tively. All patients were male, aged from 38 to85 years, （meanly 61.5 years）. There were 29 unilateral hernia, 2 bilateral hernia and 33 latus hernias, of them 8 cases experienced recurrence for two times and 2 three times. Twenty days to 25 years when recurrent after last repair process, average 12.5 years. Thirty-one latus hernias underwent traditional herniorrhaphy as the first process （ including 19 of Bassini, 8 of Halsted and 4 cases unknown）. The cases who experienced recurrence for two or three times were operated with traditional process. 2 cases of tension-free hernioplasty were 3DP mesh. 15 patients complicated with hypertension and coronary disease, 10 patients complicated with biabetes, 6 patients complicated with chronic obstructive pulmonary disease, 10 patients complicated with hyperplasia of prostate. Results All patients were primary healing and no recurrence was obserbed after 0. 5 to 4 years of follow-up. Conclusions The results of Millikan tension-free hernioplasty in recurrent inguinal hernia were satisfaction. Affirm the transversalic fascia correctly, liberate the preperitoneal space sufficiently and mount the mesh firmly and correctly are very critical in the process of repairing recurrent inguinal hernia.