成人腹股沟疝开放无张力修补治疗87例体会

目的探讨成人腹股沟疝开放无张力修补方法的选择。方法根据Gilbert疝分级对成人腹股沟疝进行分型。对Gilbert疝分级Ⅰ型、Ⅱ型成人腹股沟疝共41例采用平片修补法进行修补，对Gilbert分级Ⅲ～Ⅶ型的成人腹股沟疝共46例采用腹膜前铺网进行修补。结果采用平片修补法41例平均手术时间（63．7±9．5）min，平均住院时间（5．6±2．9）d，术后尿潴留2例，切口血肿2例，术后疼痛2例。采用腹膜前铺网法46例，平均手术时间（52．4±8．3）min，平均住院时间（5．3±2．7）d，术后尿潴留4例，腹壁血肿1例。无疝复发病例。结论根据不同类型疝采用不同的无张力疝修补方法，可以降低疝复发及减少并发症。

Open tension-free repair of groin hernias in adults

Objective To study open tension-free repair of different groin hernias in adults. Methods Groin hernias in adults were classified according to Gilbert classification. Lichtenstein tension-free hernioplasty was done for type Ⅰ and type Ⅱ （41 cases）,and open preperitoneal tension-free repair was done for type Ⅲ-Ⅶ （46 cases）. Results In 41 patients receiving Lichtenstein tension-free hernioplasty,the average operation time was（63. 7 ± 9. 5） rain, the average hospital stay was（5.6 ± 2.9） days. There were two cases of postoperation urinary retention, two cases of incision hematoma, and two cases of postoperation groin pain. In 46 patients receiving open preperitoneal tension-free repair, the average operation time was （52. 4 ± 8. 3） rain, and the average hospital stay was（5.3 ± 2. 7） days. There were 4 cases of postoperation urinary retention,and one case of abdominal wall hematoma. No recurrence occurred in all 87 cases. Conclusion The different tension-free repair ways are selected based on different inguinal hernias, and the incidence of recurrence and postoperation complications can be decreased.