腹股沟直疝疝囊进入阴囊机制分析

目的 探讨腹股沟直疝疝囊进入阴囊的机制.方法 回顾性分析中山大学附属孙逸仙纪念医院胃肠外科2002年1月至2012年12月收治的20例疝囊进入阴囊的腹股沟直疝患者的临床资料,并复习相关文献,分析腹股沟直疝疝囊进入阴囊的发生机制.结果 20例患者均行腹股沟疝无张力修补术,手术顺利完成,平均手术时间（41±5） min,平均住院时间（3.4±0.6）d;术后无慢性疼痛、阴囊水肿等并发症发生;随访6个月至10年,未见复发.结论 高龄患者组织退行性变,加之病程长、腹内压增高等因素,导致逐渐增大的腹股沟直疝疝囊不断挤压并突破外环口而进入阴囊.

Analysis of the mechanism that the sac of direct inguinal hernia descends into the scrotum

Objective This article is aimed to explore the mechanism that the sac of direct inguinal hernia descends into the scrotum. Methods Clinical data of 20 patients with inguinal hernia whose hernia sac descended into the scrotum treated in Sun Yat-sen Memorial Hospital of Sun Yat-sen University from January 2002 to December 2012 was analyzed retrospectively, and related literature was reviewed, to discuss how the sac of direct inguinal hernia descends into the scrotum. Results All the 20 patients underwent tension-free inguinal hernia repair successfully. The mean operative time was （41 ± 5 ） minutes; and the mean hospital stay time was （3.4 ± 0.6） days. Chronic pain, scrotal edema or other complications were not observed after operation. No recurrence was observed during the follow-up （ from 6 months to 10 years）. Conclusions The increseent sac of direct inguinal hernia presses constantly and breaks through the external inguinal ring into the scrotum, owing to degeneration of elderly patient＇s organizations, long duration and higher abdominal pressure.