• 中國醫(yī)學(xué)科學(xué)院北京協(xié)和醫(yī)學(xué)院北京協(xié)和醫(yī)院基本外科(北京 100730);

目的  介紹1例因外傷后恥骨缺損造成反復(fù)復(fù)發(fā)腹股溝疝的治療經(jīng)驗(yàn)。
方法  回顧性分析該患者的診治經(jīng)過,總結(jié)治療經(jīng)驗(yàn)。
結(jié)果  該患者在外院接受左側(cè)腹股溝疝修補(bǔ)術(shù)(Lichtenstein法),術(shù)后1年左側(cè)腹股溝疝復(fù)發(fā),再于筆者所在醫(yī)院先后接受兩次手術(shù)治療。第1次行開放的雙側(cè)腹膜前間隙無張力疝修補(bǔ)術(shù),術(shù)后1年再次復(fù)發(fā),復(fù)發(fā)原因可能是補(bǔ)片下界固定不可靠。第2次的術(shù)式與第1次相同,術(shù)后患者恢復(fù)良好,隨訪16個(gè)月無復(fù)發(fā)。
結(jié)論  外傷后恥骨缺損是疝修補(bǔ)術(shù)后復(fù)發(fā)的主要原因,堅(jiān)固有效的補(bǔ)片支撐點(diǎn)是防止再次復(fù)發(fā)的關(guān)鍵。

引用本文: 劉子文,孫蒙清,肖毅. 外傷后反復(fù)腹股溝區(qū)包塊40余年1例報(bào)道. 中國普外基礎(chǔ)與臨床雜志, 2013, 20(12): 1349-1351. doi: 復(fù)制

1. 中華醫(yī)學(xué)會(huì)外科學(xué)分會(huì)疝和腹壁外科學(xué)組. 成人腹股溝疝診療指南(2012年版)[J]. 中華外科雜志, 2013, 51(1):4-6.
2. Junge K, Rosch R, Klinge U, et al. Risk factors related to recurr-ence in inguinal hernia repair:a retrospective analysis[J].Hernia, 2006, 10(4):309-315.
3. Henriksen NA, Sorensen LT, Bay-Nielsen M, et al. Direct andrecurrent inguinal hernias are associated with ventral hernia repair:a database study[J]. World J Surg, 2013, 37(2):306-311.
4. Bittner R, Schwarz J. Inguinal hernia repair:current surgical techniques[J]. Langenbecks Arch Surg, 2012, 397(2):271-282.
5. Kocijan R, Sandberg S, Chan YW, et al. Anatomical changes after inguinal hernia treatment:a reason for chronic pain and rec-urrent hernia?[J]. Surg Endosc, 2010, 24(2):395-399.
6. Yang J, Tong da N, Yao J, et al. Laparoscopic or Lichtensteinrepair for recurrent inguinal hernia:a meta-analysis of randomizedcontrolled trials[J]. ANZ J Surg, 2013, 83(5):312-318.
7. Amid PK. How to avoid recurrence in Lichtenstein tension-free hernioplasty[J]. Am J Surg, 2002, 184(3):259-260.
8. Benfatto G, Catania G, D’Antoni S, et al. Recurrence after hernioplasty according to Lichtenstein:analysis of the cause[J]. G Chir, 2002, 23(11-12):427-430.
9. Felix E, Scott S, Crafton B, et al. Causes of recurrence after lapa-roscopic hernioplasty. A multicenter study[J]. Surg Endosc,1998, 12(3):226-231.
10. Shamim M. Recurrent inguinal hernia due to mesh dissolution:two case reports[J]. Hernia, 2010, 14(3):313-315.
11. Karthikesalingam A, Markar SR, Holt PJ, et al. Meta-analysis of randomized controlled trials comparing laparoscopic with open mesh repair of recurrent inguinal hernia[J]. Br J Surg, 2010, 97(1):4-11.
12. van den Heuvel B, Dwars BJ. Repeated laparoscopic treatment of recurrent inguinal hernias after previous posterior repair[J]. Surg Endosc, 2013, 27(3):795-800.
13. Memon AA, Siddiqui FG, Abro AH, et al. Management of recurrent inguinal hernia at a tertiary care hospital of southern Sindh, Pakistan[J]. World J Surg, 2013, 37(3):510-515.
14. El-Dhuwaib Y, Corless D, Emmett C, et al. Laparoscopic versus open repair of inguinal hernia:a longitudinal cohort study[J]. Surg Endosc, 2013, 27(3):936-945.
15. Jang IS, Lee SM, Kim JH, et al. Clinical usefulness of laparoscopic total extraperitoneal hernia repair for recurrent inguinal hernia[J]. J Korean Surg Soc, 2011, 80(5):313-318.
16. Goo TT, Lawenko M, Cheah WK, et al. Endoscopic total extra-peritoneal repair of recurrent inguinal hernia:a 5-year review[J].Hernia, 2010, 14(5):477-480.
17. Dedemadi G, Sgourakis G, Radtke A, et al. Laparoscopic versusopen mesh repair for recurrent inguinal hernia:a meta-analysis of outcomes[J]. Am J Surg, 2010, 200(2):291-297.
18. Katri KM. Open preperitoneal mesh repair of recurrent inguinal hernia[J]. Hernia, 2009, 13(6):585-589.
  1. 1. 中華醫(yī)學(xué)會(huì)外科學(xué)分會(huì)疝和腹壁外科學(xué)組. 成人腹股溝疝診療指南(2012年版)[J]. 中華外科雜志, 2013, 51(1):4-6.
  2. 2. Junge K, Rosch R, Klinge U, et al. Risk factors related to recurr-ence in inguinal hernia repair:a retrospective analysis[J].Hernia, 2006, 10(4):309-315.
  3. 3. Henriksen NA, Sorensen LT, Bay-Nielsen M, et al. Direct andrecurrent inguinal hernias are associated with ventral hernia repair:a database study[J]. World J Surg, 2013, 37(2):306-311.
  4. 4. Bittner R, Schwarz J. Inguinal hernia repair:current surgical techniques[J]. Langenbecks Arch Surg, 2012, 397(2):271-282.
  5. 5. Kocijan R, Sandberg S, Chan YW, et al. Anatomical changes after inguinal hernia treatment:a reason for chronic pain and rec-urrent hernia?[J]. Surg Endosc, 2010, 24(2):395-399.
  6. 6. Yang J, Tong da N, Yao J, et al. Laparoscopic or Lichtensteinrepair for recurrent inguinal hernia:a meta-analysis of randomizedcontrolled trials[J]. ANZ J Surg, 2013, 83(5):312-318.
  7. 7. Amid PK. How to avoid recurrence in Lichtenstein tension-free hernioplasty[J]. Am J Surg, 2002, 184(3):259-260.
  8. 8. Benfatto G, Catania G, D’Antoni S, et al. Recurrence after hernioplasty according to Lichtenstein:analysis of the cause[J]. G Chir, 2002, 23(11-12):427-430.
  9. 9. Felix E, Scott S, Crafton B, et al. Causes of recurrence after lapa-roscopic hernioplasty. A multicenter study[J]. Surg Endosc,1998, 12(3):226-231.
  10. 10. Shamim M. Recurrent inguinal hernia due to mesh dissolution:two case reports[J]. Hernia, 2010, 14(3):313-315.
  11. 11. Karthikesalingam A, Markar SR, Holt PJ, et al. Meta-analysis of randomized controlled trials comparing laparoscopic with open mesh repair of recurrent inguinal hernia[J]. Br J Surg, 2010, 97(1):4-11.
  12. 12. van den Heuvel B, Dwars BJ. Repeated laparoscopic treatment of recurrent inguinal hernias after previous posterior repair[J]. Surg Endosc, 2013, 27(3):795-800.
  13. 13. Memon AA, Siddiqui FG, Abro AH, et al. Management of recurrent inguinal hernia at a tertiary care hospital of southern Sindh, Pakistan[J]. World J Surg, 2013, 37(3):510-515.
  14. 14. El-Dhuwaib Y, Corless D, Emmett C, et al. Laparoscopic versus open repair of inguinal hernia:a longitudinal cohort study[J]. Surg Endosc, 2013, 27(3):936-945.
  15. 15. Jang IS, Lee SM, Kim JH, et al. Clinical usefulness of laparoscopic total extraperitoneal hernia repair for recurrent inguinal hernia[J]. J Korean Surg Soc, 2011, 80(5):313-318.
  16. 16. Goo TT, Lawenko M, Cheah WK, et al. Endoscopic total extra-peritoneal repair of recurrent inguinal hernia:a 5-year review[J].Hernia, 2010, 14(5):477-480.
  17. 17. Dedemadi G, Sgourakis G, Radtke A, et al. Laparoscopic versusopen mesh repair for recurrent inguinal hernia:a meta-analysis of outcomes[J]. Am J Surg, 2010, 200(2):291-297.
  18. 18. Katri KM. Open preperitoneal mesh repair of recurrent inguinal hernia[J]. Hernia, 2009, 13(6):585-589.