目的探讨腹股沟直疝突入阴囊的可能原因及其手术修补方法。 方法回顾性分析笔者所在医院2005年6月至2013年6月期间收治的353例次腹股沟直疝患者的临床资料。 结果353例次腹股沟直疝患者，发生疝囊突入阴囊12例次，发生率为3.4%。与未突入阴囊组比较，突入阴囊组患者的年龄大、病程长、疝环口及疝囊大，且多伴有慢性支气管炎、便秘等导致慢性腹内压增高的疾患。12例次中采用“疝环充填+平片”修补术1例次，其余11例次均采用腹膜前修补术。术后随访6～60个月，平均37个月，无复发病例。 结论腹股沟直疝在少数情况下可以突入阴囊，宜选择腹膜前间隙疝无张力修补术。
ObjectiveTo compare the effects of medical glue and stapling in the prevention of postoperative seroma for patients undergoing laparoscopic direct hernia repair. MethodsNinty-four patients were randomly by computer generated randomization number divided into two groups: medical glue group (medical glue was used to fix pseudo-direct hernia sac) and stapling group (staple was used to fix pseudo-direct hernia sac).The time of follow-up was two years.The operative time, length of hospital stay, the pain level on first day and 7th day after operation, postoperative complications (seroma, wound infection, wound bleeding), hospital costs, and hernia recurrence rate within 2 years were observed. ResultsThe medical glue group compared with the stapling group, the operative time was shorter〔(35±5.1) min vs.(41±7.5) min〕, hospitalization time was shorter〔(4±0.51) d vs.(5±0.83) d〕, lower postoperative pain score〔the first day: (5±0.52) scores vs.(6±0.33)scores; the 7th day: (3±0.67) scores vs.(4±0.53) scores〕, and lower cost in hospital〔(5 731±560.50) yuan vs.(8 715±534.33) yuan〕, there were significant difference (P < 0.05).The incidence of seroma and other complications after operation and postoperative 1-year and 2-year hernia recurrence rate showed no significant differences (P > 0.05). ConclusionsThe medical glue has good prevention effects on postoperative seroma for patients undergoing laparoscopic direct hernia surgery, with shorter operative time and lower cost.This method is suitable for all levels of hospitals