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find Keyword "疝" 235 results
  • 巨大滑疝的修复

    在158例腹股沟疝中的5例滑疝,采用双侧腹股沟U形切口,术中妥善保护肠管并维护其良好血运。对松弛的腹横筋膜给予部分切除交叉重叠缝合,使之恢复正常张力和强度。对扩大的内环也给予缝合缩小,腹股沟管应用Mc Vay法修补,均取得良好效果,随防1年未见复发。

    Release date:2016-09-01 11:18 Export PDF Favorites Scan
  • 改良Nissen手术在滑动性食管裂孔疝治疗中的应用

    目的评价改良Nissen手术在滑动性食管裂孔疝治疗中的应用价值。 方法回顾性分析自2001年6月至2013年5月蚌埠医学院第一附属医院52例滑动性食管裂孔疝经手术治疗患者的临床资料,其中男27例、女25例,平均年龄62.13(35~84)岁。所有患者术前均行上消化道X线钡餐造影、胃镜检查确诊为滑动性食管裂孔疝,均行改良Nissen手术,即胃底上提至贲门口上方2~3 cm,包绕双层缝合固定食管180°,并置于膈肌下方。分别于术后3个月、6个月、9个月在平卧头低位下行消化道X线钡餐检查,并长期随访,以评价手术效果。 结果本组均顺利完成手术,无手术死亡,患者术前存在的食管下括约肌松弛和胃酸反流,术后均明显改善。术后平均住院时间9(5~11)d。52例患者术后2周内复查上消化道X线钡餐检查,无胃食管反流。所有患者均随访,随访时间2个月至10年。除1例术后半年并发食管狭窄外,其余患者均恢复顺利,症状消失,营养及发育好转。随访期间无复发。 结论改良Nissen手术是治疗滑动性食管裂孔疝的有效方法,加强食管下段高压区,折叠胃及贲门口置于膈肌下方,不仅能使胃还纳腹腔,同时还有抗反流的效果。

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  • Diagnosis and Treatment of Incarcerated Paraesophageal Hernia

    目的 探讨嵌顿性食管旁疝的诊断和外科治疗。方法 对我院手术治疗的4例嵌顿性食管旁疝患者的临床资料进行分析。结果 2例急诊剖腹探查确诊,2例经胸部X线平片和CT检查确诊; 4例均行经腹Hill胃背侧固定术,术后均无并发症,无疝复发。结论 胸部X线平片及CT检查是诊断本病的主要手段; 一旦获得诊断或高度怀疑,应及早手术治疗; 经腹Hill胃背侧固定术式简单、可靠、复发率低,适合基层医院医生掌握。

    Release date:2016-08-28 04:47 Export PDF Favorites Scan
  • Tension-Free Repair of Middle and Small Incisional Hernia by Modified Kugel Patch Reports of 25 Cases

    目的 探讨带记忆弹簧圈(MK)补片在无张力修补中、小切口疝中的应用。方法 回顾性分析2005年1月至2007年1月期间我院实施MK补片下置术修补腹壁中、小切口疝25例患者的临床资料,其中初发21例,复发4例。结果 22例一期愈合,3例发生切口皮下积液,经穿刺抽吸处理后治愈。住院7~15 d,均痊愈出院。随访10个月至2年,无复发病例。结论 用MK补片下置术修补腹壁中、小切口疝经济、安全、有效、感染风险降低。

    Release date:2016-09-08 11:05 Export PDF Favorites Scan
  • Clinical Study of Laparoscopic Transabdominal Preperitoneal Inguinal Hernia Repair for Recurrent Inguinal Hernia after Inguinal Hernioplasty with Plug Prefix Mesh

    ObjectiveTo investigate the surgical skills and clinical effects of the laparoscopic transabdominal preperitoneal (TAPP) inguinal hernia repair in treatment of recurrent inguinal hernia with plug prefix mesh. MethodsThe clinical data such as operation time, intraoperative blood loss, postoperative hospital stay, and postoperative complications of 87 patients with recurrent inguinal hernia reoperated in laparoscopic TAPP after inguinal hernioplasty with plug prefix mesh (recurrent hernia group), in the Department of Gastroenterology and Hernia surgery of the First Affiliated Hospital of Kunming Medical University from January 2011 to December 2013, were retrospectively analyzed, which were compared with the 834 incipient inguinal hernia patients operated first by TAPP (incipient hernia group) at the same time. ResultsThe operations were completed successfully in all of the 921 patients without conversion to open surgery. The operation time and intraoperative blood loss in the recurrent hernia group were significantly more than those in the incipient hernia group (P=0.000, P=0.000), the postoperative hospital stay had no signifcant difference between two groups (P=0.057). No recurrences were observed in the recurrent hernia group and incipient hernia group for following-up of (31±4) months and (28±6) months, respectively. Compared with the incipient hernia group, the rates of postoperative pain on day 30 and seroma on day 1 and 3 were higher in the recurrent hernia group (P=0.001, P=0.040, P=0.003, respectively). There were no severe complications such as collateral damage, foreign body sensation, incision infection, intestinal obstruction and so on in the two groups. ConclusionsThe laparoscopic TAPP inguinal hernia repair is safe and effective for patients with recurrent inguinal hernia with plug prefix mesh. More skills are required to reduce the complications. The operation time and intraoperative blood loss in reoperated patients with recurrent inguinal hernia are more than those in patients with incipient inguinal hernia. The rates of seroma on day 1 and 3 are also higher.

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  • CLINICAL RESEARCH OF LAPAROSCOPIC BUNDLED FASTIGIATED MESH IN REPAIRING INGUINAL HERNIA

    Objective To explore the method and effectiveness of laparoscopic bundled fastigiated mesh in repairing inguinal hernia. Methods Between January 2003 and December 2009, 1 215 patients (1 363 sides) with inguinal hernia were treated. There were 1 132 males (1 268 sides) and 83 females (95 sides), aged from 18 to 89 years (median, 58 years). The cases included 1 187 cases (1 329 sides) of primary hernia and 28 cases (34 sides) of recurrent hernia. There were indirect inguinal hernia in 728 cases (786 sides), direct inguinal hernia in 416 cases (499 sides), femoral hernia in 43 cases (45 sides), and unusual hernia in 28 cases (33 sides). According to the hernia classification criteria, there were 31 cases (38 sides) in type I, 683 cases (754 sides) of type II, 403 cases (452 sides) of type III, and 98 cases (119 sides) of type IV. The disease duration was 1 to 9 days with an average of 3.8 days. To repair the hernia, the bundled fastigiated mesh was patched through the internal inguinal ring and fixed on the internal inguinal fascia by three-point fixation. The mesh would be wrapped in the peritoneum by purse-string suture. Results The surgeries were performd successfully. The operative time ranged from 18-32 minutes (mean, 22 minutes). Postoperative tractional pain in the inguinal region occurred in 19 cases (21 sides), acute uroschesis in 8 cases, and far-end hernial sac effusion in 2 cases (2 sides); all were cured after symptomatic treatment. All incisions healed by first intention, and no complications of fever, infection, or hematoma occurred. A total of 1 095 cases (1 182 sides) were followed up 1 to 7 years (median, 3 years and 9 months). Five patients died of medical illnesses at 1-3 years after operation. Three cases recurred and then were cured by a second surgery. No intestinal adhesion or obstruction occurred. Conclusion The bundled fastigiated mesh in laparoscopic inguinal hernia repair has the advantages of minimal invasiveness, easy-to-operate, less complications, and lower recurrence rate.

    Release date:2016-08-31 05:45 Export PDF Favorites Scan
  • Value of Laparoscopy in Treatment of Acute Inguinal Incarcerated Hernia (Report of 11 Cases )

    Objective To investigate the value of laparoscopy in resetting and repairing of inguinal incarcerated hernia. Methods Clinical data of 11 patients with acute inguinal incarcerated hernia treated with laparoscopy from March 2007 to February 2008 were reviewed, including 3 cases of direct inguinal hernia and 8 cases of oblique inguinal hernia. Results There were 7 patients with incarcerated hernia who were reset automatically after general anaesthesia, and 4 patients who were reset with laparoscopy. All the hernias were repaired with the transabdominal preperitoneal (TAPP) method after observed or improved the blood cycle of the incarcerated intestinal tract under laparoscopy. Average follow-up time was 6.6 months (2-12 months) after operation. Good recover and no recurrence were showed in all patients. Conclusion Laparoscopy is a safe technology in resetting and repairing of inguinal incarcerated hernia

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  • THE PROPHYLAXES, DIAGNOSIS AND TREATMENT OF PELVI-PERITONEAL HERNIA AFTER MILES OPERATION FOR RECTAL CARCINOMA

    Objective To investigate the prophylaxes, diagnosis and treatment of pelvi-peritoneal hernia (PPH) after Miles operation for rectal carcinoma. Methods Three hundred and nine patients who underwent Miles operation from January 1986 to June 1999 were collected and analysed retrospectively, 11 of them were complicated with PPH. Results The morbidity of PPH after Miles operation was 3.6% (11/309). The main manifestations included abdominal distention to some extent (11 cases), pain (3 cases), vomiting (2 cases), gastric liquid more than 500 ml a day by gastric tube (3 cases), and non-exsufflation of the stoma of colostomy (11 cases). Two cases had pea green small intestinal liquid by perineal tube. The signs were slight abdominal tender (5 cases), active or excessive intestinal gurgling sound (7 cases), and diminished intestinal gurgling sound (4 cases). Abdominal plane films, showing the distant small intestinal obstruction, were taken in all 11 cases. Only 2 patients were correctly diagnosed before reoperation, and other patients were regarded as adhesive intestinal obstruction. The average observational time following appearance of the clinical manifestations after Miles operation was 7.4 days. All patients were diagnosed by laparotomy, 3 of them underwent adhesion lysis and reposition, and 8 patients partial ileum resection and anastomosis. The content of the hernias was ileum. The morbidity after reoperation was 27.3% (3 cases), and the complication was wound infection. All 11 patients were cured and left hospital. Conclusion The PPH after Miles operation is often lack of typical clinical manifestations. The early diagnosis and laparotomy in time is key to management. It is important to prevent the complication.

    Release date:2016-09-08 02:01 Export PDF Favorites Scan
  • Experience of Treatment of Inguinal Groove Incarcerated Hernia with Small Intestine Necrosis by Plug Mesh Tension-Free Hernioplasty (Report of 21 Cases)

    目的评价应用疝环充填式无张力疝修补术治疗腹股沟嵌顿疝并发小肠坏死的手术效果。方法对于我院2001年5月至2009年5月期间收治的21例腹股沟嵌顿疝并发小肠坏死患者应用疝环充填式无张力疝修补术给予一期修补,先行坏死肠管切除,后置入网塞。结果无手术死亡病例,1例患者发生切口感染,经换药后治愈。平均住院时间65 d。全部患者随访6个月至8年,平均51个月,未见复发。结论 疝环充填式无张力疝修补具有创伤小、安全及患者恢复快的优点,对于腹股沟嵌顿疝并发小肠坏死可以行一期修补,临床效果满意。

    Release date:2016-09-08 10:41 Export PDF Favorites Scan
  • The Factors for Defecation Change after Inguinal Hernia Mesh-repairs

    目的 了解局部麻醉下腹股沟疝无张力修补术后患者排便变化的相关影响因素。 方法 采用自行设计的问卷调查表,对2010年5月-6月行无张力修补术的腹股沟疝患者术后排便情况及变化进行调查,并就相关影响因素采用logistic回归方法进行统计分析。 结果 腹股沟疝无张力修补术后患者进食量减少、活动量减少、饮食成分变化、担心排便引起复发是术后排便变化的影响因素。 结论 加强该病症术后健康宣传,指导患者正常进食、多活动,消除患者对腹股沟疝复发的焦虑,可促进其早期排便。Objective To research on the risk factors for change of defecation after inguinal hernia mesh-repairs under local anesthesia. Methods Self-made questionnaires were used to investigate the defecation change among patients having undergone inguinal hernia mesh-repairs from May to June 2010, and the correlated factors for change of defecation were analyzed by logistic regression analysis. Results Reduction of activity and food, changes of food ingredients, and worries about recurrence were risk factors for change of defecation. Conclusion In order to facilitate the recovery of the patients, nurses should promote patients’ knowledge on the surgery, guide them to eat as usual and do more exercises, and eliminate their anxiety on recurrence of the disease.

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