切换至 "中华医学电子期刊资源库"

中华疝和腹壁外科杂志(电子版) ›› 2020, Vol. 14 ›› Issue (01) : 14 -17. doi: 10.3877/cma.j.issn.1674-392X.2020.01.004

所属专题: 文献

临床论著

腹股沟疝无张力修补术后补片感染的外科治疗
罗文钦1, 杨世炜1, 王永1,(), 伍兵2, 谢妍妍1, 雷文章1   
  1. 1. 610041 成都,四川大学华西医院胃肠外科
    2. 610041 成都,四川大学华西医院放射科
  • 收稿日期:2019-05-28 出版日期:2020-02-18
  • 通信作者: 王永
  • 基金资助:
    四川省卫生和计划生育委员会科研项目(150141); 四川省科技厅项目(2015JY0184); 吴阶平医学基金会临床科研专项资助(320.6750.16207)

Clinical effect of debridement for mesh infection after inguinal tension-free hernia repair

Wenqin Luo1, Shiwei Yang1, Yong Wang1,(), Bing Wu2, Yanyan Xie1, Wenzhang Lei1   

  1. 1. Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, Chengdu 610041, China
  • Received:2019-05-28 Published:2020-02-18
  • Corresponding author: Yong Wang
引用本文:

罗文钦, 杨世炜, 王永, 伍兵, 谢妍妍, 雷文章. 腹股沟疝无张力修补术后补片感染的外科治疗[J/OL]. 中华疝和腹壁外科杂志(电子版), 2020, 14(01): 14-17.

Wenqin Luo, Shiwei Yang, Yong Wang, Bing Wu, Yanyan Xie, Wenzhang Lei. Clinical effect of debridement for mesh infection after inguinal tension-free hernia repair[J/OL]. Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition), 2020, 14(01): 14-17.

目的

探讨腹股沟疝无张力修补术后,补片感染的临床治疗经验。

方法

采用回顾性横断面研究方法,收集2012年5月至2018年1月四川大学华西医院收治的35例腹股沟疝无张力修补术后感染患者的临床资料。观察指标:(1)手术及术后情况包括术后并发症情况、术后住院时间、抗生素的选择和使用。(2)随访情况包括术后再感染和远期并发症情况。采用电话、门诊或住院方式对患者进行6个月的随访,了解患者术后再感染及远期并发症发生情况。随访时间截止至2018年7月。正态分布的计量资料采用±s表示。

结果

(1)手术及术后情况:35例腹股沟疝无张力修补术后感染患者均接受补片取出术,术后均使用抗生素抗感染治疗及创面敞开引流或安置引流管负压引流,其中行局麻手术患者2例,行全麻手术患者33例。35例补片取出中有3例补片侵及肠管,其中2例行肠切除吻合,1例补片侵蚀肠管为阑尾,行阑尾切除术。平均术后住院时间为(6.72±3.43)d。(2)随访情况:术后随访6个月,随访期间患者无术后并发症发生。患者术后随访均无腹股沟疝复发。

结论

对腹股沟疝无张力修补术后补片感染患者,行补片取出术安全可靠,在处理补片感染时应及时手术。

Objective

To investigate the clinical effect of debridement for mesh infection after inguinal tension-free hernia repair.

Methods

The retrospective cross-sectional study was conducted.The clinical data of 35mesh infection patients after inguinal tension-free hernia repair who were admitted to West China Hospital of Sichuan University form May 2012 to January 2018 were collected. Observation indicators: (1) preoperative and surgical situations: complication, duration of hospital stay and antibiotics; (2) Follow-up situations: recurrence and long-term complications of debridement for mesh infection. Followup using telephone interview, outpatient examination and inpatient examination was performed to detect the hernia recurrence andlong-term complications for 3 months up to July 2018. Measurement data with normal distribution were represented as ±s.

Results

(1)Surgical and postoperative situations: 35 mesh infection patients underwent successful debridement. Postoperatively, all patients were treated with systemic antibiotic therapy and received indwelling plasma drainage-tube after debridement. 33 patients with general anaesthesia debridement were done. 2 patients with local anaesthesia were done. Of 35 patients, 3 intestinal perforation was found. The duration of hospital stay was (6.72±3.43) days. (2) Follow-up situation: All patients were followed up for 3 months, without recurrence and related complications of inguinal hernia.

Conclusion

Debridement for mesh removal was also a commendatory method for mesh infection. Debridement for mesh removal should be considered if no improvement after a 2-week conservative management.

图2 患者,男性,23岁,右侧腹股沟疝术后补片感染伴窦道形成,术中见窦道周围感染灶约4.0 cm×3.0 cm大小,美蓝沿窦道示踪后,清除感染组织,钝性分离并去除网塞和补片组,完整取出网片
[1]
唐健雄,李健文,李基业, 等. 成人腹股沟疝诊疗指南(2014年版)[J/CD]. 中华疝和腹壁外科杂志(电子版), 2014, 8(3): 204-206.
[2]
Johanet H, Contival N, Coelio C. Mesh infection after inguinal hernia mesh repair[J]. J Visc Surg, 2011, 148(5): e392-394.
[3]
Meagher H, Clarke Moloney M, Grace PA. Conservative management of mesh-site infection in hernia repair surgery: a case series[J]. Hernia, 2015, 19(2): 231-237.
[4]
Luhmann A, Moses A. Successful conservative treatment of a candida albicans intraperitoneal mesh infection following laparoscopic ventral hernia repair[J]. Hernia, 2015, 19(5): 845-847.
[5]
Tolino MJ, Tripoloni DE, Ratto R, et al. Infections associated with prosthetic repairs of abdominal wall hernias: pathology, management and results[J]. Hernia, 2009, 13(6): 631-637.
[6]
Junge K, Klinge U, Rosch R, et al. Decreased collagen type I/III ratio in patients with recurring hernia after implantation of alloplastic prostheses[J]. Lang Arch Surg, 2004, 389(1): 17-22.
[7]
Rehman S, Khan S, Pervaiz A, et al. Recurrence of inguinal herniae following removal of infected prosthetic meshes: a review of the literature[J]. Hernia, 2012, 16(2): 123-126.
[8]
Tolino MJ, Tripoloni DE. Late-onset deep mesh infection after inguinal hernia repair[J]. Hernia, 2008, 12(1): 107.
[9]
Stremitzer S, Bachleitner-Hofmann T, Gradl B, et al. Mesh graft infection following abdominal hernia repair: risk factor evaluation and strategies of mesh graft preservation. A retrospective analysis of 476 operations[J]. World J Surg, 2010, 34(7): 1702-1709.
[10]
Chung L, Tse GH, O'Dwyer PJ. Outcome of patients with chronic mesh infection following abdominal wall hernia repair[J]. Hernia, 2014, 18(5): 701-704.
[11]
Yang L, Wang H, Liang X, et al. Bacteria in hernia sac: an important risk fact for surgical site infection after incarcerated hernia repair[J]. Hernia, 2015, 19(2): 279-283.
[12]
Delikoukos S, Tzovaras G, Liakou P, et al. Late-onset deep mesh infection after inguinal hernia repair[J]. Hernia, 2007, 11(1): 15-17.
[13]
Akyol C, Kocaay F, Orozakunov E, et al. Outcome of the patients with chronic mesh infection following open inguinal hernia repair[J]. J Korean Surg Soc, 2013, 84(5): 287-291.
[14]
Reilly JS, Baird D, Hill R. The importance of definitions and methods in surgical wound infection audit[J]. J Hosp Infect, 2001, 47(1): 64-66.
[1] 奚玲, 仝瀚文, 缪骥, 毛永欢, 沈晓菲, 杜峻峰, 刘晔. 基于肌少症构建的造口旁疝危险因素预测模型[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(01): 48-51.
[2] 嵇振岭, 陈杰, 唐健雄. 重视复杂腹壁疝手术并发症的预防和处理[J/OL]. 中华疝和腹壁外科杂志(电子版), 2024, 18(06): 601-606.
[3] 江志鹏, 钟克力, 陈双. 复杂腹壁疝手术后腹腔高压与腹腔间室综合征的预防和处理[J/OL]. 中华疝和腹壁外科杂志(电子版), 2024, 18(06): 612-615.
[4] 王学虎, 赵渝. 复杂腹壁疝手术中血管损伤并发症的预防和处理[J/OL]. 中华疝和腹壁外科杂志(电子版), 2024, 18(06): 616-619.
[5] 曹能琦, 张恒, 郑立锋, 陶庆松, 嵇振岭. Ad-Hoc 自裁剪补片用于造口旁疝Sugarbaker 修补术[J/OL]. 中华疝和腹壁外科杂志(电子版), 2024, 18(06): 620-623.
[6] 皮尔地瓦斯·麦麦提玉素甫, 李慧灵, 艾克拜尔·艾力, 李赞林, 王志, 克力木·阿不都热依木. 生物补片修补巨大复发性腹壁切口疝临床疗效分析[J/OL]. 中华疝和腹壁外科杂志(电子版), 2024, 18(06): 624-628.
[7] 马东扬, 李斌, 陆安清, 王光华, 雷文章, 宋应寒. Gilbert 与单层补片腹膜前疝修补术疗效的随机对照研究[J/OL]. 中华疝和腹壁外科杂志(电子版), 2024, 18(06): 629-633.
[8] 林凯, 潘勇, 赵高平, 杨春. 造口还纳术后切口疝的危险因素分析与预防策略[J/OL]. 中华疝和腹壁外科杂志(电子版), 2024, 18(06): 634-638.
[9] 王浩源, 汪海洋, 孙建明, 陈以宽, 祁小桐, 唐博. 腹腔镜与开放修补对肝硬化腹外疝患者肝功能及凝血的影响[J/OL]. 中华疝和腹壁外科杂志(电子版), 2024, 18(06): 654-659.
[10] 周正阳, 陈凯, 仇多良, 邵乐宁, 吴浩荣, 钟丰云. 腹腔镜腹股沟疝修补术后出血原因分析及处理[J/OL]. 中华疝和腹壁外科杂志(电子版), 2024, 18(06): 660-664.
[11] 顾熙, 徐子宇, 周澍, 张吴楼, 张业鹏, 林昊, 刘宗航, 嵇振岭, 郑立锋. 腹股沟疝腹膜前间隙无张力修补术后补片感染10 例报道[J/OL]. 中华疝和腹壁外科杂志(电子版), 2024, 18(06): 665-669.
[12] 宋俊锋, 张珍珍. 单侧初发性腹股沟斜疝老年患者经腹腹膜前疝修补术中残余疝囊腹直肌下缘固定效果评估[J/OL]. 中华疝和腹壁外科杂志(电子版), 2024, 18(06): 670-674.
[13] 高娟, 徐建庆, 闫芳, 丁盛华, 刘霞. Rutkow、TAPP、TEP 手术治疗单侧腹股沟疝患者的临床疗效及对血清炎症因子水平的影响[J/OL]. 中华疝和腹壁外科杂志(电子版), 2024, 18(06): 675-680.
[14] 于新峰, 曾琦, 后强, 徐浩, 操谢芳. 腹腔镜经腹腹膜前疝修补术和腹腔镜完全腹膜外疝修补术对成人腹股沟疝治疗效果及预后分析[J/OL]. 中华疝和腹壁外科杂志(电子版), 2024, 18(06): 681-686.
[15] 臧宇, 姚胜, 朱新勇, 戎世捧, 田智超. 低温等离子射频消融治疗腹壁疝术后补片感染的临床效果[J/OL]. 中华疝和腹壁外科杂志(电子版), 2024, 18(06): 687-692.
阅读次数
全文


摘要


AI


AI小编
你好!我是《中华医学电子期刊资源库》AI小编,有什么可以帮您的吗?