《嵌顿性腹股沟疝腹腔镜诊治流程中国专家共识（2024版）》解读
董瑞朝负责资料收集和撰写；庄秋林、丁佐佑、徐静负责文献查阅与审查；杨子昂负责指导。
收稿日期: 2026-01-07
网络出版日期: 2026-04-21
Interpretation of Chinese expert consensus on laparoscopic diagnosis and treatment algorithm for incarcerated inguinal hernia (2024 edition)
Received date: 2026-01-07
Online published: 2026-04-21
董瑞朝 , 庄秋林 , 丁佐佑 , 徐静 , 杨子昂 . 《嵌顿性腹股沟疝腹腔镜诊治流程中国专家共识（2024版）》解读[J]. 外科理论与实践, 2026 , 31(01) : 36 -44 . DOI: 10.16139/j.1007-9610.2026.01.07
Incarcerated inguinal hernia is a common surgical emergency, traditionally treated primarily with open surgery. In recent years, laparoscopic techniques have gradually gained attention, but there is a lack of relevant consensus in China. This article was based on the pioneering Chinese expert consensus on laparoscopic diagnosis and treatment algorithm for incarcerated hernia (2024 edition), jointly formulated by the Hernia and Abdominal Wall Surgery Group and the Laparoscopic and Endoscopic Surgery Group of the Surgery Branch of the Chinese Medical Association. Combining evidence-based evidence and clinical practice, it further interpreted the scientificity of its methods, organized core opinions, and described the clinical implementation process oriented toward clinical scenarios. The aim was to provide practical solutions for clinical doctors, especially grassroots physicians, offering the most direct scheme support, to enhance the therapeutic outcomes for patients with incarcerated hernia and reduce complications and mortality rates.
| [1] | 中华医学会外科学分会疝与腹壁外科学组, 中国医师协会外科医师分会疝和腹壁外科医师委员会. 成人腹股沟疝诊断和治疗指南(2018 年版)[J]. 中国实用外科杂志, 2018, 38(7):704-706. |
| Hernia and Abdominal Wall Surgery Group, Chinese Medical Association, Hernioplasty and Abdominal Wall Surgeons Committee, Chinese College of Surgeons. Guidelines for diagnosis and treatment on the adult groin hernia (2018 edition)[J]. Chin J Pract Surg, 2018, 38(7):704-706. | |
| [2] | CHOWBEY P. Complications inguinal hernias: strangulated incarcerated and obstructed hernias[M]// CHOWBEYP, LOMANTOD. Techniques of abdominal wall hernia repair. New Delh: Springer India, 2020:163-168. |
| [3] | MCEACHRON K R, RAMASWAMY A. The treatment of incarcerated and strangulated inguinal hernias[M]// HOPEW W, COBBW S, ADRALESG L. Textbook of hernia. Switzerland: Springer Cham, 2017:169-175. |
| [4] | SERMONESI G, TIAN BWCA, VALLICELLI C, et al. Cesena guidelines: WSES consensus statement on laparoscopic- first approach to general surgery emergencies and abdominal trauma[J]. World J Emerg Surg, 2023, 18(1):57. |
| [5] | 唐健雄, 郑民华, 李健文, 等. 嵌顿性腹股沟疝腹腔镜诊治流程中国专家共识(2024版)[J]. 中国实用外科杂志, 2024, 44(7):721-729. |
| TANG J X, ZHENG M H, LI J W, et al. Chinese expert consensus on laparoscopic diagnosis and treatment algorithm for incarcerated inguinal hernia (2024 Edition)[J]. Chin J Pract Surg, 2024, 44(7):721-729. | |
| [6] | LAI S D, SMITH N J, PARK B, et al. Laparoscopic versus open approach for emergency repair of groin hernias: a systematic review and meta-analysis[J]. World J Surg, 2025, 49(10):2733-2741. |
| [7] | NILSSON H, STYLIANIDIS G, HAAPAM?KI M, et al. Mortality after groin hernia surgery[J]. Ann Surg, 2007, 245(4):656-660. |
| [8] | 李绍杰, 李绍春, 苏远涛, 等. 嵌顿性腹股沟疝急诊手术术式选择及疗效分析(附单中心10年497例报告)[J]. 中国实用外科杂志, 2023, 43(6):688-691. |
| LI S J, LI S C, SU Y T, et al. Selection and analysis of therapeutic effects of emergency surgical procedures for incarcerated inguinal hernia (report of 497 cases in a single center over 10 years)[J]. Chin J Pract Surg, 2023, 43(6):688-691. | |
| [9] | 杨硕, 王明刚, 曹金鑫, 等. 腹腔镜经腹腹膜前修补术治疗嵌顿性腹股沟疝的手术要点及并发症的处理(附73 例报告)[J]. 腹腔镜外科杂志, 2016, 21(2):95-98. |
| YANG S, WANG M G, CAO J X, et al. The manipulation key points and complications management of laparoscopic transabdominal preperitoneal repair for incarcerated inguinal hernia: with a report of 73 cases[J]. J Laparoendosc Surg, 2016, 21(2):95-98. | |
| [10] | 黄建朋, 陈亮, 韩明福. 腹腔镜经腹腹膜前疝修补术治疗嵌顿性腹股沟疝的应用价值[J]. 中华疝和腹壁外科杂志(电子版), 2016, 10(6):460-461. |
| HUANG J P, CHEN L, HAN M F. Application value of TAPP for incarcerated inguinal hernia[J]. Chin J Hernia Abdom Wall Surg (Electronic Edition), 2016, 10(6):460-461. | |
| [11] | 张炜宇, 李俊生, 范新, 等. 无张力修补术在腹股沟嵌顿疝手术中的应用体会[J]. 中华普通外科学文献(电子版), 2017, 11(2):129-131. |
| ZHANG W W, LI J S, FAN X, et al. Application experience of tension-free hernioplasty for incarcerated inguinal hernia[J]. Chin Arch Gen Surg (Electronic Edition), 2017, 11(2):129-131. | |
| [12] | TANAKA N, UCHIDA N, OGIHARA H, et al. Clinical study of inguinal and femoral incarcerated hernias[J]. Surg Today, 2010, 40(12):1144-1147. |
| [13] | MAZZOTTA E, COPPOLA A, CARANNANTE F, et al. How to do hernioscopy for incarcerated femoral hernia with laparoscopic O-ring retractor system[J]. ANZ J Surg, 2020, 90(11):2353-2354. |
| [14] | TEBALA G D, KOLA-ADEJUMO A, YEE J. Hernioscopy: a reliable method to explore the abdominal cavity in incarcerated or strangulated inguinal hernias spontaneously reduced after general anaesthesia[J]. Hernia, 2019, 23(2):403-406. |
| [15] | SAJID M S, LADWA N, COLUCCI G, et al. Diagnostic laparoscopy through deep inguinal ring: A literature- based review on the forgotten approach to visualize the abdominal cavity during emergency and elective groin hernia repair[J]. Surg Laparosc Endosc Percutan Tech, 2013, 23(3):251-254. |
| [16] | REINKE C E, MATTHEWS B D. What's new in the ma-nagement of Incarcerated hernia[J]. J Gastrointest Surg, 2020, 24(1):221-230. |
| [17] | BIRINDELLI A, SARTELLI M, DI SAVERIO S, et al. 2017 update of the WSES guidelines for emergency repair of complicated abdominal wall hernias[J]. World J Emerg Surg, 2017, 12:37. |
| [18] | DE SIMONE B, BIRINDELLI A, ANSALONI L, et al. Emergency repair of complicated abdominal wall hernias: WSES guidelines[J]. Hernia, 2020, 24(2):359-368. |
| [19] | WALLE K A V, GREENBERG J A. Strangulated inguinal hernia: options and strategies[M]//DAVIS J S S, DAKIN G, BATES A. The SAGES manual of hernia surgery. New York: Springer, 2019:503-514. |
| [20] | COMPAGNA R, ROSSI R, FAPPIANO F, et al. Emergency groin hernia repair: implications in elderly[J]. BMC Surg, 2013, 13(suppl 2):29. |
| [21] | KOIZUMI M, SATA N, KANEDA Y, et al. Optimal timeline for emergency surgery in patients with strangulated groin hernias[J]. Hernia, 2014, 18(6):845-848. |
| [22] | SASAKI A, TAKEUCHI Y, IZUMI K, et al. Two-stage laparoscopic treatment for strangulated inguinal, femoral and obturator hernias: totally extraperitoneal repair followed by intestinal resection assisted by intraperitoneal laparoscopic exploration[J]. Hernia, 2016, 20(3):483-488. |
| [23] | Hernia Surge Group. International guidelines for groin hernia management[J]. Hernia, 2018, 22(1):1-165. |
| [24] | ZHANG C, WANG R, LV G, et al. Laparoscopic inguinal herniorrhaphy with incarcerated bowel retraction using、"hernia sac injection impact technology": video presentation[J]. Asian J Surg, 2023, 46(1):645-646. |
| [25] | SIOW S L, MAHENDRAN H A, HARDIN M, et al. Laparoscopic transabdominal approach and its modified technique for incarcerated scrotal hernias[J]. Asian J Surg, 2013, 36(2):64-68. |
| [26] | REBUFFAT C, GALLI A, SCALAMBRA M S, et al. Laparoscopic repair of strangulated hernias[J]. Surg Endosc, 2006, 20(1):131-134. |
| [27] | LEE S R. Feasibility of laparoscopic transabdominal preperitoneal hernioplasty for incarcerated inguinal hernia[J]. JSLS, 2021, 25(3):e2021. |
| [28] | LIU J, SHEN Y, NIE Y, et al. If laparoscopic technique can be used for treatment of acutely incarcerated/strangulated inguinal hernia?[J]. World J Emerg Surg, 2021, 16(1):5. |
| [29] | 杨良根, 朱俊强, 胡星辰. 腹腔镜经腹腹膜前疝修补术治疗嵌顿性腹股沟疝[J]. 外科理论与实践, 2022, 27(6):551-554. |
| YANG L G, ZHU J Q, HU X C. Transabdominal preperitoneal laparoscopic hernia repair in treatment of incarcerated inguinal hernia[J]. J Surg Concepts Pract, 2022, 27(6):551-554. | |
| [30] | DE ALMEIDA MEDEIROS K A, CARVALHO B J, PIPEK L Z, et al. Treating incarcerated inguinal hernias with TEP is a viable option for experienced surgeons[J]. Sci Rep, 2020, 10(1):20858. |
| [31] | 胡安然, 王永忠, 郑福榕, 等. 腹腔镜全腹膜外疝修补术治疗腹股沟嵌顿疝的临床分析[J]. 腹腔镜外科杂志, 2018, 23(2):105-108. |
| HU A R, WANG Y Z, ZHENG F R, et al. Clinical analysis of laparoscopic totally extraperitoneal prosthesis for the patients with inguinal incarcerated hernia[J]. J Laparoendosc Surg, 2018, 23(2):105-108. | |
| [32] | SAKAMOTO T, FUJIOGI M, ISHIMARU M, et al. Comparison of postoperative infection after emergency inguinal hernia surgery with enterectomy between mesh repair and non-mesh repair: a national database analysis[J]. Hernia, 2022, 26(1):217-223. |
| [33] | BESSA S S, KATRI K M, ABDEL-SALAM W N, et al. Early results from the use of the Lichtenstein repair in the management of strangulated groin hernia[J]. Hernia, 2007, 11(3):239-242. |
| [34] | ELSEBAE M M, NASR M, SAID M. Tension- free repair versus Bassini technique for strangulated inguinal hernia: a controlled randomized study[J]. Int J Surg, 2008, 6(4):302-305. |
| [35] | PANDEY H, THAKUR D S, SOMASHEKAR U, et al. Use of polypropylene mesh in contaminated and dirty strangulated hernias: short-term results[J]. Hernia, 2018, 22(6):1045-1050. |
| [36] | 张子华, 毛鑫鑫. 嵌顿性腹股沟疝的补片修补[J]. 世界最新医学信息文摘, 2018, 18(78):82. |
| ZHANG Z H, MAO X X. Mesh repair for incarcerated inguinal hernia[J]. World Latest Med Inf, 2018, 18(78):82. | |
| [37] | ZANONI A A G, DELCARRO A, CICCARESE F, et al. Laparoscopic transperitoneal hernia repair (TAPP) in emergency: long-term follow- up in a high volume centre[J]. Hernia, 2022, 26(4):1063-1068. |
| [38] | 胡星辰, 李绍杰, 唐健雄, 等. 聚丙烯补片运用于嵌顿性腹股沟疝的临床评价(附46例报告)[J]. 中华疝和腹壁外科杂志(电子版), 2017, 11(3):171-173. |
| HU X C, LI S J, TANG J X, et al. Clinical evaluation of polypropylene patch applied to incarcerated inguinal hernia: a report of 46 cases[J]. Chin J Hernia Abdom Wall Surg (Electronic Edition), 2017, 11(3):171-173. | |
| [39] | DE SIMONE B, CATENA F, BIONDI A, et al. Incisional hernia repair in contaminated surgical fields (ihrcs) study using biological prostheses in emergency surgery setting with contaminated hernias: a multicenter prospective observational study[J]. J Peritoneum, 2016, 1(2):26. |
| [40] | HAN J G, PANG G Y, WANG Z J, et al. The combined application of human acellular dermal matrix and vacuum wound drainage on incarcerated abdominal wall hernias[J]. Int J Surg, 2014, 12(5):452-456. |
| [41] | 中华医学会外科学分会疝与腹壁外科学组. 青年腹股沟疝诊断和治疗中国专家共识(2020 版)[J]. 中国实用外科杂志, 2020, 40(7):754-757. |
| Hernia and Abdominal Wall Surgery Group, Chinese Medical Association. Chinese expert consensus on diagnosis and treatment of youth inguinal hernia (2020)[J]. Chin J Pract Surg, 2020, 40(7):754-757. | |
| [42] | 邹振玉, 曹金鑫, 朱熠林, 等. 腹腔镜腹股沟疝修补术后补片感染的外科治疗[J]. 中华消化外科杂志, 2023, 22(9):1080-1085. |
| ZOU Z Y, CAO J X, ZHU Y L, et al. Surgical treatment of mesh infection after laparoscopic inguinal hernia repair[J]. Chin J Dig Surg, 2023, 22(9):1080-1085. | |
| [43] | MANCINI R, PATTARO G, SPAZIANI E. Laparoscopic trans-abdominal pre- peritoneal (TAPP) surgery for incarcerated inguinal hernia repair[J]. Hernia, 2019, 23(2):261-266. |
| [44] | OIDA T, KAWASAKI A, MIMATSU K, et al. Mesh vs. non-mesh repair for inguinal hernias in emergency operations[J]. Hepatogastroenterology, 2012, 59(119):2112-2114. |
| [45] | HOFFMAN A, LESHEM E, ZMORA O, et al. The combined laparoscopic approach for the treatment of incarcerated inguinal hernia[J]. Surg Endosc, 2010, 24(8):1815-1818. |
| [46] | DUAN S J, DING N Y, LIU H S, et al. A novel bowel necrosis classification system and examination of patient outcomes in incarcerated groin hernia patients[J]. Int Surg, 2015, 100(1):96-100. |
| [47] | ATILA K, GULER S, INAL A, et al. Prosthetic repair of acutely incarcerated groin hernias: a prospective clinical observational cohort study[J]. Langenbecks Arch Surg, 2010, 395(5):563-568. |
| [48] | NAKASHIMA K, RYU S, OKAMOTO A, et al. Intestinal blood flow evaluation using the indocyanine green fluorescence imaging method in a case of incarcerated obturator hernia: a case report[J]. Asian J Endosc Surg, 2021, 14(3):565-569. |
| [49] | RYU S, YOSHIDA M, OHDAIRA H, et al. Blood flow evaluation using pinpoint? in a case of incarcerated inguinal hernia: a case report[J]. Asian J Endosc Surg, 2017, 10(1):75-78. |
| [50] | 张晨波, 李健文. 应用腹腔镜技术治疗腹股沟嵌顿疝争议与挑战[J]. 中国实用外科杂志, 2015, 35(5):502-505. |
| ZHANG C B, LI J W. Controversies and challenges of laparoscopic surgery for incarcerated inguinal hernia[J]. Chin J Pract Surg, 2015, 35(5):502-505. | |
| [51] | 翁山耕, 陈易平, 刘国忠, 等. 腹股沟疝急诊手术治疗原则[J]. 中国实用外科杂志, 2023, 43(6)671-675. |
| WENG S G, CHEN Y P, LIU G Z, et al. Principles of emergency surgery for inguinal hernia[J]. Chin J Pract Surg, 2023, 43(6):671-675. | |
| [52] | CAO J X, ZHANG C, LI H Y, et al. Rationale and design of a prospective,multicenter,randomized controlled trial of postoperative venous thromboembolism prophylaxis in Chinese adult patients with inguinal hernia (CHAT- 3 trial)[J]. Ann Palliat Med, 2021, 10(10):11141-11147. |
| [53] | WANG M, ZHANG G, CHEN J, et al. Current prevalence of perioperative early venous thromboembolism and risk factors in Chinese adult patients with inguinal hernia (CHAT- 1)[J]. Sci Rep, 2020, 10(1):12667. |
| [54] | KLONIS C, ASHRAF H, CABALAG C S, et al. Optimal timing of perioperative chemical thromboprophylaxis in elective major abdominal surgery: a systematic review and meta- analysis[J]. Ann Surg, 2023, 277(6):904-911. |
| [55] | 王明刚, 李航宇, 张光永, 等. 我国成年人腹股沟疝围手术期静脉血栓栓塞症发生率和相关因素现状调查(CHAT-1)[J]. 中国实用外科杂志, 2019, 39(8):815-820. |
| WANG M G, LI H Y, ZHANG G Y, et al. Investigation of prevalence for perioperative venous thromboembolism and risk factors of the present situation in Chinese adults patient with inguinal hernia(CHAT-1)[J]. Chin J Pract Surg, 2019, 39(8):815-820. | |
| [56] | 李绍春, 李绍杰, 唐健雄. 疝与腹壁外科围手术期静脉血栓栓塞症防治要点[J]. 中国实用外科杂志, 2020, 40(5):524-527. |
| LI S C, LI S J, TANG J X. Key points of prevention and treatment of venous thromboembolism in hernia and abdominal wall surgery[J]. Chin J Pract Surg, 2020, 40(5):524-527. | |
| [57] | 刘雨辰, 张洪铭, 张子超, 等. 腹股沟疝围手术期静脉血栓栓塞症预防方案持续改进研究(CHAT-3)[J]. 中国实用外科杂志, 2022, 42(3):293-297. |
| LIU Y C, ZHANG H M, ZHANG Z C, et al. Study on continuous improvement of prevention program of perioperative venous thromboembolism for ingui-nal hernia(CHAT-3)[J]. Chin J Pract Surg, 2022, 42(3):293-297. | |
| [58] | 北京大学医学部急诊医学学系. 成人非创伤性急腹症早期镇痛专家共识[J]. 中国急救医学, 2021, 41(1):11-17. |
| Emergency Medicine Department, Peking University Health Science Center. Expert consensus on early analgesia for adult non-traumatic acute abdominal pain[J]. Chin J Emerg Med, 2021, 41(1):11-17. | |
| [59] | 孙嘉宾. 急诊科急腹症患者的镇痛策略临床研究[J]. 世界最新医学信息文摘 (连续型电子期刊), 2019, 19(99):199-200. |
| SUN J B. Clinical study of analgesic strategies in emergency patients with acute abdominal pain[J]. World Latest Med Inf (Electronic Edition), 2019, 19(99):199-200. | |
| [60] | MATTHEWS B D, REINKE C E. Emergency hernia surgery: what to know when evaluating a patient with an incarcerated hernia[M]//RENTON D, LIM R, GALLO A S, et al. The SAGES manual of acute care surgery. New York: Springer, 2020:185-197. |
| [61] | EMILE S H, ELGENDY H, SAKR A, et al. Outcomes following repair of incarcerated and strangulated ventral hernias with or without synthetic mesh[J]. World J Emerg Surg, 2017, 12:31. |
| [62] | YANG L, WANG H, LIANG X, et al. Bacteria in hernia sac: an important risk fact for surgical site infection after incarcerated hernia repair[J]. Hernia, 2015, 19(2):279-283. |
| [63] | BESSA S S, ABDEL-FATTAH M R, AL SAYES I A, et al. Results of prosthetic mesh repair in the emergency management of the acutely incarcerated and/or strangulated groin hernias: a 10-year study[J]. Hernia, 2015, 19(6):909-914. |
| [64] | S?TER A H, FONNES S, ROSENBERG J, et al. High complication and mortality rates after emergency groin hernia repair: a nationwide register- based cohort study[J]. Hernia, 2022, 26(4):1131-1141. |
| [65] | JACOB R, GUY S B, KAMILA L, et al. Comparison of emergent laparoscopic and open repair of acutely incarcerated and strangulated hernias-short and long-term results[J]. Surg Endosc, 2023, 37(3):2154-2162. |
| [66] | PAWLAK M, EAST B, DE BEAUX A C. Algorithm for management of an incarcerated inguinal hernia in the emergency settings with manual reduction. Taxis, the technique and its safety[J]. Hernia, 2021, 25(5):1253-1258. |
| [67] | MISEREZ M, PEETERS E, AUFENACKER T, et al. Update with level 1 studies of the european hernia society guidelines on the treatment of inguinal hernia in adult patients[J]. Hernia, 2014, 18(2):151-163. |
| [68] | DAI W, CHEN Z, ZUO J, et al. Risk factors of postoperative complications after emergency repair of incarcerated groin hernia for adult patients: a retrospective cohort study[J]. Hernia, 2019, 23(2):267-276. |
/
| 〈 |
|
〉 |
