Lichtenstein procedure

  • 文章类型: Case Reports
    一名49岁的女性患有复杂的疝气,包括直接和间接腹股沟疝,Spigelian疝,还有Pantaloon疝气,出现在病例报告中。通过全面的体格检查和影像学检查证实了诊断。这导致了列支敦士登的修复手术。疝气的外科手术包括艰苦的解剖,疝囊减少,植入假肢网.该实例强调了个性化治疗方案的价值,并提请注意疝气手术的复杂解剖细节。分析彼此相似的情况强调了定制策略以改善患者预后的必要性。
    A 49-year-old woman with a complicated hernia presentation, including direct and indirect inguinal hernias, Spigelian hernias, and Pantaloon hernias, is presented in the case report. The diagnosis was verified by a comprehensive physical examination and imaging, which resulted in a Lichtenstein operation for repair. The surgical procedure for hernia comprised of painstaking dissection, reduction of the hernia sac, and implantation of a prosthetic mesh. The instance emphasizes the value of individualized treatment programs and draws attention to the intricate anatomical details of hernia surgery. Analyzing situations that are similar to one another highlights the necessity of customized strategies to improve patient outcomes.
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  • 文章类型: Journal Article
    阴茎Mondor病(PMD)是一种罕见的综合征,其特征是阴茎浅静脉的浅表血栓性静脉炎后硬化。PMD最常见的外观是招标,明显的,痛苦,有时在阴茎背面可见的绳索。其发病机制尚不清楚,标准化治疗尚未建立。
    一名54岁男性患者出现左侧间接复位腹股沟疝。患者接受Lichtenstein腹股沟疝修补术。术后第十天,他返回时,经多普勒超声检查证实为PMD。每天用4000UI低分子量肝素(LMWH)治疗三周,缓解了症状,但轻微的静脉扩张只是阴茎的近端部分仍然存在。
    PMD的确切原因尚不清楚,但是各种研究已经确定了与这种疾病风险增加相关的某些因素。在各种可能引发PMD的潜在因素中,腹股沟疝的修复仅有一次报道。治疗可能涉及疼痛管理,抗炎药,抗凝剂,and,在某些情况下,手术。
    开放式疝修补术后的PMD是一种非常罕见的良性疾病。正确的诊断和及时的治疗可以缓解症状。残余静脉扩张除了外观外观外没有临床意义。
    UNASSIGNED: Penile Mondor\'s disease (PMD) is a rare syndrome characterized by sclerosis after superficial thrombophlebitis of the superficial penile veins. The most usual appearance of PMD is a tender, palpable, painful, and sometimes visible cord on the dorsal surface of the penis. Its pathogenesis is still unclear, and a standardized treatment has not been established.
    UNASSIGNED: A 54-year-old male patient presented with a left-sided indirect reducible inguinal hernia. The patient underwent Lichtenstein\'s procedure for inguinal hernia repair. On the tenth postoperative day, he returned with PMD confirmed by Doppler ultrasonography examination. Treatment with 4000 UI low molecular weight heparin (LMWH) daily for three weeks resolved the symptoms, but mild venous ectasia just to the proximal part of the penis remained.
    UNASSIGNED: The exact cause of PMD is not well understood, but various studies have identified certain factors associated with an increased risk of the condition. Out of various potential factors that could trigger PMD, the repair of an inguinal hernia has been reported only once. Treatment may involve pain management, anti-inflammatory medications, anticoagulants, and, in some cases, surgery.
    UNASSIGNED: PMD after open hernia repair surgery is a very rare benign condition. Correct diagnosis and prompt treatment allowed symptom resolution. Residual venous ectasia has no clinical significance other than a cosmetic appearance.
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  • 文章类型: Journal Article
    腹股沟疝修补术是普通外科最常见的手术之一。除了经典的开放手术,腹腔镜技术,如经腹腹膜前疝修补术(TAPP)和完全腹膜外疝修补术(TEP),已经获得认可,并且越来越多地用于腹股沟疝修补,这三种技术是腹股沟疝修补的唯一标准。这项研究旨在比较使用TAPP补片技术和Lichtenstein技术对成年患者进行腹股沟疝修补的结果,这些结果涉及手术后一天感觉到的疼痛程度和住院天数。对129例接受TAPP与TAPP的患者进行了为期两年的研究。109例接受列支敦士登疝修补术的患者。我们的结果显示了两个变量的统计学意义(Tpain(233)=-7.12,p<0.001,d=2.92;住院天数(233)=-31.34,p<0.001,d=4.01)。TAPP是腹股沟疝修补术的安全方法,与传统的列支敦士登技术相比,可以快速恢复并减少术后疼痛。
    Inguinal hernia repairs are one of the most common procedures in general surgery. In addition to classical open surgery, laparoscopic techniques, such as transabdominal preperitoneal (TAPP) and total extraperitoneal (TEP) hernia repair, have gained acceptance and are increasingly used for inguinal hernia repairs, and these three techniques are the only standards for inguinal hernia repairs. This study aimed to compare the results of inguinal hernia repairs in adult patients using the TAPP patch technique and Lichtenstein techniques regarding the level of pain perceived one day after surgery and the number of days of hospitalization. A two-year study was performed on 129 patients who underwent TAPP vs. 109 patients who underwent Liechtenstein hernia repair. Our results revealed statistical significance for both variables (Tpain(233) = -7.12, p< 0.001, d=2.92; Tdays of hospitalization(233) = -31.34, p< 0.001, d=4.01). TAPP is a safe method for inguinal hernia repairs, allowing quick recovery and less postoperative pain than the classical Liechtenstein technique.
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  • 文章类型: Journal Article
    背景:腹股沟疝修补术是一种常见的外科手术。心血管疾病患者术后发病率的手术风险增加。该研究旨在确定对这些患者最有益的外科手术。
    方法:纳入2015年12月至2020年2月期间接受单侧或双侧腹股沟疝择期手术的患者。将该队列分为有心血管疾病患者组(CVD组)和无心血管疾病患者组(NO组),并根据术后发病率分布进行分析,并与所使用的手术技术相关。
    结果:在474例患者中,有223例(47%)使用Lichtenstein技术进行手术,有251例(53%)使用TAPP进行手术,分别。在CVD组中,Lichtenstein程序更为常见(n=102,68.9%),NO组是TAPP(n=205,62.9%;p<0.001)。CVD组13例(8.8%)患者和NO组12例(3.7%)患者发生术后血肿(p=0.023)。在进一步的亚组分析中,CVD组显示,香豆素治疗是术后血肿发展的危险因素,而腹腔镜方法并没有增加发病风险。
    结论:CVD是普外科围手术期发病率的已知危险因素,然而,TAPP方法不会增加个体围手术期风险.
    BACKGROUND: Inguinal hernia repair is a common procedure in surgery. Patients with cardiovascular disease have an increased operative risk for postoperative morbidity. The study aimed to identify the most beneficial surgical procedure for these patients.
    METHODS: Patients undergoing elective surgery for unilateral or bilateral inguinal hernia between December 2015 and February 2020 were included. The cohort was divided into the group of patients with (CVD group) and without (NO group) cardiovascular disease and analyzed according to the postoperative morbidity distribution and correlated to the surgical technique used.
    RESULTS: Of the 474 patients included 223 (47%) were operated on using the Lichtenstein technique and 251 (53%) using TAPP, respectively. In the CVD group the Lichtenstein procedure was more common (n = 102, 68.9%), in the NO group it was TAPP (n = 205, 62.9%; p < 0.001). 13 (8.8%) patients in the CVD group and 12 (3.7%) patients in the NO group developed a postoperative hematoma (p = 0.023). In the further subgroup analysis within the CVD group revealed cumarine treatment as a risk factor for postoperative hematoma development, whereas the laparoscopic approach did not elevate the morbidity risk.
    CONCLUSIONS: CVD is a known risk factor for perioperative morbidity in general surgery, however, the TAPP method does not elevate the individual perioperative risk.
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  • 文章类型: Journal Article
    OBJECTIVE: The inguinal hernia accounts for 50 percent in old age males. A Lichtenstein type of operation has now become the method of choice in most developed countries but in the developing world traditional simple suture repair is still in common practice in resource limited hospitals due to the scarcity and expensive nature of the commercial prosthetic mesh. Our objective was to compare the rates of complications in Lichtenstein repair to tension free Darn repair.
    METHODS: Ninety two male patients from 20-60 years of age reported for direct or indirect inguinal hernia with open Mesh/Lichtenstein or darn repair in emergency or electively from January 2014 to December 2015 were enrolled in this prospective randomized control trial (RCT). The primary end point was to compare the surgical site infection, length of hospital stay and hernia recurrence with different techniques.
    RESULTS: The hospital stay was higher in patients who had Lichtenstein repair, Superficial surgical site infections in cohort A (6.5%) and cohort B (4.36%)were noted. Complications of recurrence in Group-A were (1.5%) as compared to Group-B which had a recurrence of 6.52%.
    CONCLUSIONS: Lichtenstein is more promising in comparison to Darn repair in terms of recurrence in inguinal hernia.
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  • 文章类型: Journal Article
    BACKGROUND: The ideal operation to treat inguinal hernia is still far to define. We analyzed the outcomes of the Desarda tissue-based repair in comparison with the standard Lichtenstein procedure in treatment of primary inguinal hernia.
    METHODS: A total of 168 patients were randomly allocated into two groups to undergo one of two repairs: Desarda (group I) or Lichtenstein (group II) (85 vs. 83, respectively). The primary outcome measures were recurrence of inguinal hernia and chronic groin pain. Secondary outcome measures included operating time, postoperative pain scores, time to return to normal gait and to work, foreign body sensation in the groin, and postoperative complications.
    RESULTS: During 2-year follow up, one recurrence was detected in each group (P = 0.99). Chronic groin pain was experienced by 5.6% and 4.2% of patients from Desarda and Lichtenstein groups respectively (P = 0.68). There was no significant statistical difference in mean postoperative VAS scores for pain at the five time points between the two study groups. There was significantly shorter operating time and earlier return to normal gait in favor of Desarda repair. Foreign body sensation was not different between the two groups.
    CONCLUSIONS: Successful inguinal hernia treatment without mesh implantation can be achieved using Desarda repair, as it is effective as the standard Lichtenstein procedure. Shorter operating time, early return to normal gait and lower cost (no mesh) are potential benefits of Desarda repair. The suitability of Desarda repair for patients found to have thin, weak or divided external oblique aponeurosis intraoperatively needs further evaluation.
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  • 文章类型: Journal Article
    BACKGROUND: With an average incidence rate of 11%, chronic pain is considered the most serious complication of inguinal hernioplasty after surgical site infection. One of the proposed solutions to this problem is to use tissue adhesive for mesh fixation, which helps prevent nerve and tissue damage.
    OBJECTIVE: The goal of this study was to compare mesh fixation with the use of sutures vs. adhesive in Lichtenstein\'s inguinal hernia repair in a randomized, double-blind one-center study.
    METHODS: The study group consisted of 41 males with primary inguinal hernia undergoing Lichtenstein\'s repair (20 - adhesive; 21 - suture) and remaining in follow-up from July 2008 to November 2010. Randomization took place during the operation. The follow-up was performed by one surgeon (blinded) according to a pre-agreed schedule; the end-of-study unblinding was performed during the last follow-up visit, usually 16 months postoperatively.
    RESULTS: In 1 patient from the \"adhesive\" group, a recurrence was observed one year after the initial repair. The early postoperative pain was less intense in this group. In later postoperative periods the method of mesh fixation had no influence on the pain experienced by the patient. Other complications were not correlated with the method of mesh fixation.
    CONCLUSIONS: In this randomized, one-center double-blind clinical study of males with primary inguinal hernia it has been show during follow-up that the use of Glubran 2 cyanoacrylate adhesive for mesh implant fixation yields similar recurrence and chronic pain rates as the classical suture technique. In the early postoperative period, the pain reported by these patients was relatively weaker; patients undergoing adhesive mesh fixation experienced a quicker return to daily household activities.
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