外科理论与实践

外科理论与实践 ›› 2021, Vol. 26 ›› Issue (05): 416-419.doi: 10.16139/j.1007-9610.2021.05.011

• 论著 • 上一篇    下一篇

Halsted术式在急诊疝修补中的应用体会

李绍春, 李绍杰, 黄磊, 蔡昭, 孟云潇, 唐健雄()   

  1. 复旦大学附属华东医院普通外科,上海 200040
  • 收稿日期:2021-08-02 发布日期:2022-07-22
  • 通讯作者: 唐健雄 E-mail:johnxiong@china.com
  • 基金资助:
    上海市疝补片不良事件监测项目(H1178)

Experience of using Halsted operation in emergency hernia repair

LI Shaochun, LI Shaojie, HUANG Lei, CAI Zhao, MENG Yunxiao, TANG Jianxiong()   

  1. Department of General Surgery, Shanghai Huadong Hospital, Fudan University, Shanghai 200040, China
  • Received:2021-08-02 Published:2022-07-22
  • Contact: TANG Jianxiong E-mail:johnxiong@china.com

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摘要： 目的 探讨Halsted术式在急诊嵌顿腹股沟疝修补中的应用。 方法 回顾性分析我科2016年1月至2018年12月收治的49例男性嵌顿腹股沟疝病人的临床资料。所有病人均行急诊手术治疗,采用Halsted术式修补。其中小肠坏死36例,大网膜嵌顿坏死6例。肠坏死切除病人留置腹腔引流管。所有病人常规第一间隙留置负压引流管。术后电话或门诊随访。 结果 49例病人手术均顺利完成。3例术后因肺部感染导致呼吸功能衰竭死亡,其余46例治愈。围术期（术后7 d）并发症发生率为10.2%（5/49）。病人术后平均随访（37.0±8.6）（24~60）个月,其中4例失访,2例复发。未出现腹股沟区感染等并发症。 结论 急诊腹股沟疝修补时,在手术区域控制感染的前提下,Halsted修补术具有操作简便、术后疼痛率低等优势,有一定的临床意义。

关键词: Halsted术式, 嵌顿疝, 疝修补术

Abstract: Objective To explore the application of Halsted operation in emergency repair of incarcerated inguinal hernia. Methods The clinical data of 49 male patients with incarcerated inguinal hernia admitted from January 2016 to December 2018 in our department were analyzed retrospectively. All the patients underwent emergency operation using Halsted hernia repair. There were 36 cases with small intestine necrosis and 6 cases with impaction necrosis of greater omentum found during operation. Drainage tube was retained in abdominal cavity for the patients with intestine necrosis and negative pressure drainage tube was inserted in first interspace. Postoperative follow-up was conducted by telephone or out-patient clinic. Results The operation was successfully completed in all 49 patients. Three cases died of respiratory failure caused by pulmonary infection, and the other 46 cases were cured. Perioperative complication was found 5 cases with incidence of 10.2% 7 days after operation. Patients were followed up for an average of (37.0±8.6)(24-60) months with 2 cases recurred and 4 cases lost follow-up. There was without any local infection of incision. Conclusions In the emergency inguinal hernia repair, Halsted repair has the advantages of simple procedure, low postoperative pain rate and has some clinical value when surgical site infection is controlled.

Key words: Halsted operation, Incarcerated hernia, Hernia repair

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