腹股沟疝无张力修补术后补片相关内脏并发症的研究进展  

Research progress of mesh‑related visceral complications after tension‑free inguinal hernia repair

作　　者：谢天皓 任项项 哈思宁 孙新利 王强[1] 刘立涛[1] 牛征 刘领云 孙谦[1] 靳小石[1] Xie Tianhao;Ren Xiangxiang;Ha Sining;Sun Xinli;Wang Qiang;Liu Litao;Niu Zheng;Liu Lingyun;Sun Qian;Jin Xiaoshi(Department of General Surgery,Affiliated Hospital of Hebei University,Baoding 071000,Hebei Province,China)

机构地区：[1]河北大学附属医院普通外科,保定071000

出　　处：《中华消化外科杂志》2022年第9期1240-1246,共7页Chinese Journal of Digestive Surgery

基　　金：河北省重点研发计划项目(21377773D);河北省医学科学研究课题计划(20211642)。

摘　　要：腹股沟疝无张力修补术后补片侵蚀导致的内脏并发症是一类少见且易被忽视的长期并发症。开放腹膜前修补术和腹腔镜修补术后至发生补片相关内脏并发症的间隔时间较短,疝环填充式修补术和经腹腹膜前疝修补术报道率最高,Lichtenstein疝修补术间隔时间最长,且报道率低。补片侵蚀的常见器官是乙状结肠、膀胱和小肠。补片侵蚀乙状结肠常见临床表现是便血、腹壁瘘管形成及结肠炎,侵蚀膀胱常见临床表现是血尿及反复尿道感染,侵蚀小肠常见的临床表现是肠梗阻及腹壁瘘管形成,侵蚀多器官临床表现是结肠膀胱瘘和小肠膀胱瘘。多数患者行补片取出联合相应器官切除或修补术疗效较好。笔者总结、分析1994—2021年腹股沟疝无张力修补术后补片相关内脏并发症的相关文献并综述其研究进展,以提高临床医师对此类并发症的认识。Mesh‑related visceral complications caused by mesh erosion after tension‑free inguinal hernia repair are one kind of rare long‑term complications,but they are easily neglected.Interval time from initial hernia repair to mesh‑related visceral complications by preperitoneal and laparoscopic repair is short.Rutkow and transabdominal preperitoneal repair have the highest reported rate.Lichtenstein has the longest interval time and the lowest reported rate.The most frequently eroded organs are sigmoid colon,bladder and small intestine.The common clinical manifestations of sigmoid colon erosion are hematochezia,abdominal wall fistula and colitis,hematuria and recurrent urinary tract infection in bladder erosion cases,intestinal obstruction and abdominal wall fistula in intestinal erosion case,sigmoid‑bladder fistula and intestinal‑bladder fistula in multiple organ erosion cases.Resection or repair of corresponding organs with mesh removal have good efficacies in most patients.The authors summarize and analyze researches on mesh‑related visceral complications after tension‑free inguinal hernia repair from 1994 to 2021,review their advances,in order to raise awareness of such complications in clinicians.

关 键 词：疝 腹股沟疝 补片侵蚀 补片迁移 补片相关内脏并发症 疝修补术 

分 类 号：R656.21[医药卫生—外科学]