腹股沟疝腹膜前间隙无张力修补术后补片感染10例报道  

Mesh infection after tension-free preperitoneal inguinal hernia repair:A report of 10 cases

作　　者：顾熙 徐子宇 周澍 张吴楼 张业鹏 林昊 刘宗航 嵇振岭 郑立锋[1] Gu Xi;Xu Ziyu;Zhou Shu;Zhang Wulou;Zhang Yepeng;Lin Hao;Liu Zonghang;Ji Zhengling;Zheng Lifeng(Department of General Surgery,Nanjing Jiangbei Hospital Affiliated to Nantong University Xinglin College,Nanjing,210048,Jiangsu Province,China;Department of General Surgery,Affiliated Zhongda Hospital,Southeast University,Nanjing 210009,Jiangsu Province,China)

机构地区：[1]南通大学杏林学院附属南京江北医院普外科,南京210048 [2]东南大学附属中大医院普通外科,南京210009

出　　处：《中华疝和腹壁外科杂志(电子版)》2024年第6期665-669,共5页Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition)

摘　　要：目的总结腹股沟疝腹膜前间隙无张力修补术后补片感染的诊治经验。方法回顾性收集2016年1月至2024年8月于南通大学杏林学院附属南京江北医院行腹股沟疝腹膜前间隙无张力修补术后补片感染的10例患者的临床资料进行分析,采用腹腔镜结合开放手术途径去除感染补片,对手术处理进行总结。结果期间共有967例腹股沟疝患者行腹股沟疝腹膜前间隙无张力修补术,术后补片感染发生率为1.03%(10/967)。患者均在硬脊膜外麻醉下接受手术,术中使用补片为聚丙烯双层补片。补片感染时间为术后(12.6±7.0)个月,培养细菌主要为金黄色葡萄球菌。补片取出方式为腹腔镜和开放联合手术,切口放置双套管冲洗引流,手术时间为(105.1±24.5)min,住院时间为(14.8±5.0)d。切口均为甲级愈合,术后随访未出现并发症。结论腹膜前间隙无张力腹股沟疝修补术后补片感染罕见,处理起来复杂。早期感染可保守治疗,迟发性感染需完整去除补片。腹腔镜和开放联合手术有利于补片取出,切口处放置双套管有助于切口的愈合。Objective To summarize the experience of diagnosis and treatment of mesh infection after tension-free preperitoneal inguinal hernia repair.Methods From January 2016 to August,2024,the clinical characteristics of 10 patients with mesh infection after tension-free preperitoneal inguinal hernia repair in Nanjing Jiangbei Hospital Affiliated to Nantong University Xinglin College were retrospectively collected and analyzed.Laparoscopic combined with open surgery was used to remove the infected mesh,and the surgical treatment was summarized.Results The incidence of mesh infection after tension-free preperitoneal inguinal hernia repair in our hospital was 1.03%(10/967).All patients received epidural anesthesia and used the polypropylene double-layer mesh in the surgery.The time of mesh infection was(12.6±7.0)months after surgery,and the main bacteria cultured were Staphylococcus aureus.The surgical method for removing mesh was laparoscopic and open combined surgery,with double-cannula drainage tube placed in the incision.The surgical time was(105.1±24.5)minutes,and the hospital stay was(14.8±5.0)days.All incisions were class A healing,and no complications were reported during postoperative follow-up.Conclusion Mesh infection after tension-free preperitoneal inguinal hernia repair is rare and complex to manage.Early infections can be managed conservatively,while late infections require complete mesh removal.The laparoscopic and open combined surgery is conducive to the removal of the mesh,and use of double-cannula drainage tube is beneficial to the healing of the incision.

关 键 词：疝 腹股沟 腹膜前间隙 无张力疝修补术 补片感染 腹腔镜辅助手术 

分 类 号：R65[医药卫生—外科学]