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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) ›› 2022, Vol. 16 ›› Issue (01) : 100 -103. doi: 10.3877/cma.j.issn.1674-392X.2022.01.024

临床论著

开放式腹膜前间隙补片修补术治疗腹股沟嵌顿或绞窄性疝的安全性和有效性
施振峰1, 郑红丽1,†(), 陶吴东1   
  1. 1. 215600　江苏苏州，张家港市第五人民医院普外科
  • 收稿日期:2020-09-09 出版日期:2022-02-18
  • 通信作者: 郑红丽

Safety and effectiveness of open preperitoneal prosthetic mesh repair for acutely incarcerated or strangulated inguinal hernia

Zhenfeng Shi1, Hongli Zheng1,†(), Wudong Tao1   

  1. 1. Department of General Surgery, Zhangjiagang Fifth People's Hospital, Zhangjiagang 215600, Jiangsu Province, China
  • Received:2020-09-09 Published:2022-02-18
  • Corresponding author: Hongli Zheng
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施振峰, 郑红丽, 陶吴东. 开放式腹膜前间隙补片修补术治疗腹股沟嵌顿或绞窄性疝的安全性和有效性[J/OL]. 中华疝和腹壁外科杂志(电子版), 2022, 16(01): 100-103.

Zhenfeng Shi, Hongli Zheng, Wudong Tao. Safety and effectiveness of open preperitoneal prosthetic mesh repair for acutely incarcerated or strangulated inguinal hernia[J/OL]. Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition), 2022, 16(01): 100-103.

目的

评估开放式腹膜前间隙补片修补术治疗腹股沟嵌顿或绞窄性疝的安全性和有效性。

方法

回顾性分析2014年4月至2019年12月于张家港市第五人民医院普外科因腹股沟嵌顿或绞窄性疝手术治疗的患者102例，根据是否应用补片修补分为观察组（52例）和对照组（50例）。比较2组患者手术时间、住院时间、视觉模拟评分法（VAS）、术后并发症发生率及复发情况。

结果

2组患者平均手术时间及住院时间比较，差异均无统计学意义（P>0.05）。2组患者术后1、6、12 h及出院时VAS评分相比较，差异均无统计学意义（P>0.05）。2组间术后并发症发生率比较，差异无统计学意义（P>0.05）。术后随访1年，观察组无复发，而对照组复发7例，差异有统计学意义（P<0.05）。

结论

开放式腹膜前间隙补片修补术治疗腹股沟嵌顿或绞窄性疝不仅安全有效，且术后复发率低，值得在临床推广应用。

关键词: 疝修补术, 疝，腹股沟, 疗效
Objective

To evaluate the safety and effectiveness of open preperitoneal prosthetic mesh repair for acutely incarcerated or strangulated inguinal hernia.

Methods

102 patients who were treated for acutely incarcerated or strangulated inguinal hernia in Department of General Surgery, Zhangjiagang Fifth People's Hospital, Suzhou, Jiangsu province from April 2014 to December 2019 were retrospectively analyzed. According to whether mesh repair was applied, they were divided into observation group (n=52) and control group (n=50). The operation time, hospital stay, Visual Analogue Scale (VAS) score, postoperative complications and recurrence were compared between the two groups.

Results

There was no significant difference in the average operation time and hospital stay between the two groups (P>0.05). There was no significant difference in VAS scores between the two groups at 1, 6, and 12 hours after operation and at discharge (P>0.05). The incidence of postoperative complications between the two groups was not statistically significant (P>0.05). During the 1-year follow-up, there was no recurrence in the observation group, while 7 cases in the control group had recurrence. The recurrence rate was statistically significant (P<0.05).

Conclusion

Open preperitoneal prosthetic mesh repair is not only safe and effective in the treatment of incarcerated or strangulated hernia, but also has a low postoperative recurrence rate, which is worthy of clinical application.

Key words: Herniorrhaphy, Hernia, inguinal, Effectiveness
表1 2组腹股沟嵌顿或绞窄性疝患者基线资料比较
组别 例数 年龄(岁,±s) 性别(例) 身体质量指数(kg/m2,±s) ASA分级(Ⅰ/Ⅱ,例) 患侧(左/右,例)
观察组 52 66±16 38/14 23.32±1.39 42/10 16/36
对照组 50 63±11 40/10 23.55±1.79 35/15 17/33
t或χ2值   0.681 0.679 0.915 1.598 0.122
P值   >0.05 >0.05 >0.05 >0.05 >0.05
组别 嵌顿疝/绞窄性疝(例) 斜疝/直疝(例) 例数 高血压 糖尿病 冠心病
观察组 42/10 32/20 52 10 6 5
对照组 38/12 32/18 50 8 8 6
t或χ2值 0.343 0.066   0.183 0.428 0.151
P值 >0.05 >0.05   >0.05 >0.05 >0.05
表2 2组患者平均手术时间及住院时间比较（±s）
组别 例数 住院时间(d) 手术时间(min)
观察组 52 5.91±1.23 68.33±10.25
对照组 50 6.21± 1.42 65.18±8.36
t或χ2   0.989 1.365
P   >0.05 >0.05
表3 2组患者术中不同时刻视觉模拟评分比较（分，±s）
组别 例数 术后1 h 术后6 h 术后12 h 出院时
观察组 52 3.85±0.62 3.02±0.36 2.56±0.22 1.12±0.23
对照组 50 4.01±0.55 3.08±0.48 2.34±0.26 1.26±0.20
t值   1.028 0.926 0.987 1.051
P值   >0.05 >0.05 >0.05 >0.05
[1]
Tebala GD, Kola-Adejumo A, Yee J. Hernioscopy: a reliable method to explore the abdominal cavity in incarcerated or strangulated inguinal hernias spontaneously reduced after general anaesthesia[J]. Hernia, 2019, 23(2): 403-406.
[2]
Yang Q, Gao Y. Incarcerated recurrent inguinal hernia as a cause of secondary torsion of the greater omentum: a rare case report and literature review[J]. J Int Med Res, 2019, 47(11): 5867-5872.
[3]
Matsuda A, Miyashita M, Matsumoto S, et al. Laparoscopic transabdominal preperitoneal repair for strangulated inguinal hernia[J]. Asian J Endosc Surg, 2018, 11(2): 155-159.
[4]
Navaratne L, Ashrafian H, Martínez-Isla A. Quantifying tension in tension-free hiatal hernia repair: a new intra-operative technique[J]. Surg Endosc, 2019, 33(9): 3040-3049.
[5]
Qin C, Chen J, Shen Y. Individualized tension-free inguinal hernia repair in elderly patients[J]. Minerva Chir, 2019, 74(3): 275-276.
[6]
唐健雄. 成人腹股沟疝诊疗指南(2018年版)解读[J]. 临床外科杂志, 2019, 27(1): 14-17.
[7]
刘景平，万智恒，李瑞斌. 腹腔镜经腹腹膜前疝修补术与开放无张力疝修补术治疗腹股沟疝的疗效比较[J/OL]. 中华疝和腹壁外科杂志(电子版), 2020, 14(5): 485-488.
[8]
Chen F, Liu M, Jin C, et al. Tension-free mesh repair for incarcerated groin hernia: a comparative study[J]. Surg Innov, 2020, 27(4): 352-357.
[9]
Martin MJ, Pakula AM. Minimally invasive approach to incarcerated or strangulated groin hernias: a 2018 EAST master class video presentation[J]. J Trauma Acute Care Surg, 2018, 85(1): 239-241.
[10]
Cai LZ, Foster D, Kethman WC, et al. Surgical site infections after inguinal hernia repairs performed in low and middle human development index countries: a systematic review[J]. Surg Infect(Larchmt), 2018, 19(1): 11-20.
[11]
Gossetti F, D'Amore L, Annesi E, et al. Mesh-related visceral complications following inguinal hernia repair: an emerging topic[J]. Hernia, 2019, 23(4): 699-708.
[12]
AlMarzooqi R, Tish S, Huang LC, et al. Review of inguinal hernia repair techniques within the Americas Hernia Society Quality Collaborative[J]. Hernia, 2019, 23(3): 429-438.
[13]
Kulacoglu H, Celasin H, Oztuna D. Individual mesh size for open anterior inguinal hernia repair: an anthropometric study in Turkish male patients[J]. Hernia, 2019, 23(6): 1229-1235.
[14]
Arnold MR, Coakley KM, Fromke EJ, et al. Long-term assessment of surgical and quality-of-life outcomes between lightweight and standard(heavyweight) three-dimensional contoured mesh in laparoscopic inguinal hernia repair[J]. Surgery, 2019, 165(4): 820-824.
[15]
Gamagami R, Dickens E, Gonzalez A, et al. Open versus robotic-assisted transabdominal preperitoneal(R-TAPP) inguinal hernia repair: a multicenter matched analysis of clinical outcomes[J]. Hernia, 2018, 22(5): 827-836.
[16]
Na Y, Sun YH, Sun ZC, et al. Mesh erosion into sigmoid colon after inguinal hernia repair[J]. Chin Med J(Engl), 2017, 130(9): 1133-1134.
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