Objective To discuss the surgical treatment and experience of mesh infection after prosthetic patch repair of inguinal hernia. Methods The clinical data of 67 cases of mesh infection after prosthetic patch repair who were treated in Chao-Yang Hospital from Jan. 2011 to Jun. 2012 were retrospectively analyzed. Results All patients were treated with surgical operation successfully， including removing the infected mesh and surrounding tissues， primary suture， and a placement of wound drainage， without replacement of a new patch substitute. The hospital stay of the patients was 10-25days with an average of 16days. Of the 67 patients， 51 patients got primary healed and the other 16 patients healed delayed after local dressing change due to the superficial infection following stitch removal. Sixty-six patients were followed-up for 6-24 months （average of 20 months） after operation without recurrence and complication， including seroma， wound infection， intestinal fistula， and postoperative pain. Conclusions The treatment of mesh infection after inguinal hernia repair is very complicated， but the primary suture repair and a placement of wound drainage after removing infected mesh with complete debridement is a effective therapy for it.
Objective To investigate the optimal surgical approach for bilateral inguinal hernias and complex (recurrent and compound) inguinal hernia. Methods Data of eighty patients with bilateral inguinal hernias and (or) complex inguinal hernias treated by tension less hernia repair between Feb. 2007 and Jun. 2010 in Sichuan Provincial People’s Hospital were analyzed. Preperitoneal approach through inferior abdominal median incision was applied in the repair with local, lumbar or epidural anesthesia. Results Operation time was （30±10.2） min in unilateral hernia, （50±17.5） min in bilateral hernia. There was no ischemic orchitis or pain case after operation. Within 3 months following up, no recurrence occurred. Conclusion The preperitoneal approach through inferior abdominal median incision for inguinal hernia repair is proved to be effective, safe, and convenient, and especially fit for bilateral hernias and complex hernia.
ObjectiveTo evaluate the curative effect of individualized tension-free hernia repair surgery in the treatment of recurrent inguinal hernia. MethodsWe retrospectively analyzed the clinical data of 31 patients with recurrent inguinal hernia treated by tension-free hernia repair surgery between August 2008 and August 2013. Among them, four underwent hernia ring pure mesh plug filling repair, 19 underwent modified Lichtenstein operation, and 8 underwent routine peritoneal clearance. ResultsPostoperative complications included one case of incision infection, 3 of incision seroma, 2 of incision scrotal hematoma, and one of urinary retention. The patients recovered well postoperatively, and the length of hospital stay ranged from 5 to 7 days. Follow-up was done for 25 patients with a time period of 4 to 38 months, averaging (10±13) months. No chronic pain or recurrence occurred during the follow-up. ConclusionIndividualized optimal treatment options of operation time and method according to patients' conditions, and simple, effective and accurate operation can get out of the dilemma of repeated recurrences.
ObjectiveTo summarize the experience of treating lower extremity deep venous thrombosis (DVT) after repair of inguinal hernia. MethodThe clinical data of 1 812 patients who underwent herniorrhaphy from January 2002 to December 2012 were reviewed, and we analyzed such data as age, gender, and the formation of DVT. ResultsFive of them suffered from DVT (0.28%), including 2 cases involving both lower extremities, 1 right and 2 left extremity. All of them were discharged from hospital by anticoagulant therapy and there was no pulmonary embolism and death case. DVT recovered well in 4 cases half a year after being discharged from the hospital. One had a sequela of recurrent swelling of the left lower extremity. ConclusionsReasonable precautions and treatment against DVT are very important even though DVT rate after inguinal hernia repair is low.
ObjectiveTo evaluate the safety and efficiency of perioperative low molecular heparin (LMH) as the replacement of anticoagulant for patients with inguinal hernia. MethodsSixty-three patients with oblique inguinal hernia from April 2009 to April 2012 in this hospital were analyzed retrospectively.Seventeen cases because of other diseases were long-term oral aspirin anticoagulant therapy (aspirin group), 11 cases because of other diseases were long-term oral warfarin anticoagulant therapy (warfarin group), anticoagulant therapy was replaced by continuing LMH 7 d before operation in the aspirin group and the warfarin group.The other 35 cases did not take any anticoagulant therapy (control group). Results①The demography and preoperative international normalized ratio were similar among three groups (P > 0.05).②All the patients were followed-up.The duration of follow-up ranged from 12 months to 18 months.There were no statistical differences of the scrotal hematoma or subcutaneous hematoma, operation time, postoperative hospital stay, and VAS scoring among these three groups (P > 0.05).There was no recurrence in all the patients. ConclusionFor a long term application of anticoagulant in patients with oblique inguinal hernia, perioperative application of LMH instead of anticoagulant does not increase the risk of bleeding, and could prevent thrombosis.
ObjectiveTo investigate the technique and early results of hybrid repair of parastomal hernia with the DynaMesh-IPST. MethodsA retrospective analysis was made on the clinical data of 28 patients who underwent DynaMesh-IPST hybrid repair of parastomal hernia between October 2013 and June 2016. There were 18 males and 10 females, aged 49-84 years (mean, 71 years). The disease duration of parastomal hernia was 6-60 months (mean, 27.6 months). The body mass index (BMI) was 17-35 (mean, 25.6); there were 15 obese patients (BMI > 26). ResultsThe operation was completed smoothly in all patients. The mean stoma diameter was 6 cm (range, 4-9 cm). The mean operation time was 142 minutes (range, 110-190 minutes). The mean hospital stay was 9 days (range, 7-12 days). Seroma was found in 2 patients, and was cured by needle aspiration and pressure bandage. All 28 cases were followed up 1-33 months (mean, 19 months). No recurrence, infection, intestinal fistula, and stoma-related problems were found. The appearance of abdominal wall was symmetrical. ConclusionDynaMesh-IPST hybrid repair is a safe and feasible method for parastomal hernia, and the short-term operative result is satisfactory.