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성인 서혜부 탈장에 대한 무긴장 탈장교정술의 임상경험

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Author(s)
강구정임정수임태진
Keimyung Author(s)
Kang, Koo JeongLim, Tae Jin
Department
Dept. of Surgery (외과학)
Journal Title
대한외과학회지
Issued Date
1999
Volume
57
Issue
6
Abstract
Background: Since the herniorrhaphy was performed by Bassini, that method has been the standard for herniorrhaphy for over a hundred year, although it has been modified by other surgeons. During recent decades, biomaterials were introduced to the medical field, and polypropylene mesh was applied to reconstruct the defective abdominal wall of an inguinal hernia in an adult. The Lichtenstein Hernia Institute is regarded as the leading group for the tension-free herniorrhaphy using Marlex mesh under local anesthesia.
Methods: We designed this study prospectively to investigate the characteristics of groin hernias and the results, including complications and recurrence after surgery. The primary method of surgery was a Lichtenstein's tension-free herniorrhaphy using Prolene mesh. We performed 196 hemioplasties in 180 patients having a groin hernia, which included 16 bilateral hernias.
Results: 139 indirect hernias, 51 direct hernias, and 3 femoral hernias were included; there were 15 recurrent hernias. A Lichtenstein’s tension-free herniorrhaphy was performed in 84.2% of the cases, a preperitoneal mesh graft in 10.2%, and a Bassinimethod in 4.6%. There were four recurrences; three were through the femoral canal after the repair of a direct hernia in a female, and one was a recurrent direct hernia in a male patient.
Conclusions: With the use of a mesh prosthesis, a tension-free herniorrhaphy is possible with neither distortion of the normal anatomy nor suture-line tension. However, it should be carefully applied to a direct hernia only after thorough exploration of the groin through the retroinguinal space of Bogros to rule out coexisting intraparietal or femoral hernias. It is necessary to provide enough laxity for the mesh because prolene mesh can shrink up to 20%, and recurrence might be caused by the tension in the applied mesh.
Alternative Title
Lichtenstein's Tension Free Herniorrhaphy in Adult Inguinal Hernia
Keimyung Author(s)(Kor)
강구정
임태진
Publisher
School of Medicine
Citation
강구정 et al. (1999). 성인 서혜부 탈장에 대한 무긴장 탈장교정술의 임상경험. 대한외과학회지, 57(6), 889–895.
Type
Article
ISSN
1226-0053
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/38203
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Surgery (외과학)
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