老年男性原发性腹股沟斜疝行改良充填式无张力疝修补术临床体会

目的总结原发性腹股沟斜疝老年男性患者行改良充填式无张力疝修补术的特点、手术技巧及围手术期治疗经验。方法回顾分析2011年1月—2014年12月因原发腹股沟斜疝在本院行改良充填式无张力修补术的162例60岁以上老年男性患者的临床资料及随访资料。结果手术时间43～92 min,均值(53.85±8.64)min,术中出血20mL～60 mL,均值(32.74±8.21)mL,术后1周活动时的VAS疼痛评分1分～5分,均值(2.46±1.09)分,住院时间2 d～8 d,均值(3.30±1.09)d。4例患者术后1 d～3 d出现阴囊水肿,发生率2.47%,1例患者术后1年出现手术部位局部线头排异反应,发生率0.61%,3例患者术后3 d～7 d出现阴囊积液,发生率1.85%。所有全程随访患者均未出现疝复发、补片感染及补片排异反应。结论改良充填式无张力疝修补术应用于老年男性原发腹股沟斜疝疗效可靠,患者经济负担小。

Clinical experience of elderly males with primary indirect inguinal hernia receiving improved plug-mesh tension-free hernia repair

Objective To summarize the characteristics, surgical techniques and perioperative treatment experience of improved plug-mesh tension-free hernia repair in elderly male patients with primary indirect inguinal hernia. Methods The clinical data and follow-up data of 162 male patients aged over 60 years who underwent the improved plug-mesh tension-free hernia repair of primary indirect inguinal hernia in our hospital from January 2011 to December 2014 were retrospectively analyzed. Results The operation time was 43-92 minutes, the mean value was 53.85±8.64 minutes, the intraoperative bleeding was 20-60ml, the mean value was 32.74±8.21ml, the VAS pain score at 1 week after the operation when active was 1-5, the mean value was 2.46±1.09, the hospitalization time was 2-8 days, and the mean value was 3.30±1.09 days. Four patients had scrotal edema on the 1-3 day after the operation, and the incidence rate was 2.47%. One case had local line knot rejection reaction in 1 years after the operation, and the incidence rate was 0.61%. Three cases had the scrotum effusion on the 3-7 days after the operation, and the incidence was 1.85%. No recurrence of hernia, patch infection and patch rejection occurred in all the patients receiving the whole course of follow-up. Conclusion The improved plug-mesh tension-free hernia repair is reliable and economic in the elderly male patients with primary indirect inguinal hernia burden.