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中华疝和腹壁外科杂志(电子版)

中华疝和腹壁外科杂志(电子版) ›› 2021, Vol. 15 ›› Issue (02) : 146 -149. doi: 10.3877/cma.j.issn.1674-392X.2021.02.007

所属专题： 经典病例； 文献；

临床论著

腹股沟疝无张力修补术后迟发性补片感染16例诊治分析
陈昕1, 毛忠琦1, 胡浩1, 徐露1, 殷骏1, 胡优1, 王钢1, 周晓俊1,†()   
  1. 1. 215006　江苏省，苏州大学附属第一医院普通外科
  • 收稿日期:2019-03-09 出版日期:2021-04-18
  • 通信作者: 周晓俊

Analysis on diagnosis and treatment of 16 cases of late-onset mesh infection after tension-free hernia repair

Xin Chen1, Zhongqi Mao1, Hao Hu1, Lu Xu1, Jun Yin1, You Hu1, Gang Wang1, Xiaojun Zhou1,†()   

  1. 1. Department of General Surgery, the First Affiliated Hospital of Soochow University, Suzhou 215006, China
  • Received:2019-03-09 Published:2021-04-18
  • Corresponding author: Xiaojun Zhou
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引用本文：

陈昕, 毛忠琦, 胡浩, 徐露, 殷骏, 胡优, 王钢, 周晓俊. 腹股沟疝无张力修补术后迟发性补片感染16例诊治分析[J]. 中华疝和腹壁外科杂志(电子版), 2021, 15(02): 146-149.

Xin Chen, Zhongqi Mao, Hao Hu, Lu Xu, Jun Yin, You Hu, Gang Wang, Xiaojun Zhou. Analysis on diagnosis and treatment of 16 cases of late-onset mesh infection after tension-free hernia repair[J]. Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition), 2021, 15(02): 146-149.

目的

探讨腹股沟疝无张力修补术后迟发性补片感染的诊断及治疗方法。

方法

回顾性分析2012年8月至2017年8月，苏州大学附属第一医院收治的16例腹股沟疝无张力修补术后补片迟发性感染患者的临床资料。观察指标：（1）一般情况（2）；手术情况；（3）术后情况；（4）随访情况。

结果

16例患者初次手术的方式包括：平片修补法（Lichtenstein），网塞填充修补法（Mesh Plug）及普理灵三合一无张力疝修补法（PHS）。补片感染时间平均为术后（7.3±2.4）个月；感染的细菌主要为金黄色葡萄球菌及大肠埃希菌；16例患者均行补片取出术，其中3例加行了腹腔镜探查术。手术时间为（66±31）min，术中出血量（32±11）ml，术后住院天数（20.4±5.4）d。术后无复发。

结论

腹股沟疝无张力修补术后迟发性补片感染少见，多需外科手术处理，补片取出术疗效确切，当怀疑补片突破腹膜时需加行腹腔镜探查术。

关键词: 疝，腹股沟, 疝修补术, 补片感染
Objective

To evaluate the methods for the diagnosis and treatment of late-onset mesh infection after tension-free hernia repair.

Methods

Clinical data of 16 patients suffered from late-onset mesh infection after tension-free hernia repair at the first affiliated hospital of Soochow University from August 2012 to August 2017 was analyzed retrospectively. Observation indicators included (1) general condition, (2) operation situations, (3) postoperative situations, (4) follow up.

Results

The initial operation of 16 patients include: Lichtenstein hernioplasty, mesh plug hernioplasty and bilayer patch device for inguinal hernia (PHS). The mean time of mesh infection was (7.3±2.4) months. Staphylococcus aureus and escherichia coli were the main pathogens. All 16 patients were performed patch removal, and 3 of them received an additional laparoscopic exploration. The operative time was (66±31) minutes, the operative blood loss was (32±11) ml and the length of postoperative stay was (20.4±5.4) days. No recurrence occurred in 16 cases.

Conclusion

Delayed mesh infection after tension-free hernia repair is rare. It mainly depends on surgical management. The patch removal has obvious curative effect. An additional laparoscopic exploration is needed when the patch breaking through the peritoneum is suspected.

Key words: Hernia, inguinal, Hernionhaphy, Mesh infection
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