BACKGROUND Mesh plug(MP)erosion into the intra-abdominal organs is a rare but serious long-term complication after inguinal hernia repair(IHR),and may lead to aggravation of symptoms if not treated promptly.It is diff...BACKGROUND Mesh plug(MP)erosion into the intra-abdominal organs is a rare but serious long-term complication after inguinal hernia repair(IHR),and may lead to aggravation of symptoms if not treated promptly.It is difficult to diagnose MP erosion as there are no obvious specific clinical manifestations,and surgery is often needed for confirmation.In recent years,with the increased understanding of postoperative complications,MP eroding into the intra-abdominal organs has been a cause for concern among surgeons.CASE SUMMARY A 50-year-old man was referred to the Department of General Surgery with the complaint of abdominal pain in the right lower quadrant for 2 d.He had a surgical history of right open IHR and partial thyroidectomy performed 20 years and 15 years ago,respectively.Computed tomography revealed a circinate highdensity image with short segmental thickening of the ileum stuck to the abdominal wall,and no evidence of recurrent inguinal hernia.Laparoscopic abdominal exploration confirmed adhesion of the middle segmental portion of the ileal loop to the right inguinal abdominal wall;the rest of the small intestine was normal.Further exploration revealed migration of the polypropylene MP into the intraperitoneal cavity and formation of granulation tissue around the plug,which eroded the ileum.Partial resection of the ileum,including the MP and end-to-side anastomosis with an anastomat,was performed.CONCLUSION Surgeons should aim to improve their ability to predict patients at high risk for MP erosion after IHR.展开更多
Objective:To explore and analyze the clinical efficacy of flat mesh tension-free hernioplasty in the treatment of patients with inguinal hernia.Methods:A total of 60 patients with inguinal hernia were included and equ...Objective:To explore and analyze the clinical efficacy of flat mesh tension-free hernioplasty in the treatment of patients with inguinal hernia.Methods:A total of 60 patients with inguinal hernia were included and equally divided into an observation group(30 cases,flat mesh tension-free hernioplasty)and a control group(30 cases,mesh plug tension-free hernioplasty)based on differences in surgical plans.The visual analog scale(VAS)for postoperative pain,inflammatory markers(C-reactive protein,white blood cell count),and complication rates were compared between the two groups.Results:At 24 and 48 hours postoperatively,the VAS scores in the observation group were significantly lower than those in the control group(P<0.05).At 24 hours postoperatively,the levels of CRP and WBC were also lower in the observation group(P<0.05).The complication rate was slightly lower in the observation group(P>0.05).Conclusion:Flat mesh tension-free hernioplasty for inguinal hernia can alleviate postoperative pain and suppress inflammatory responses,with fewer complications,making it suitable for promotion at primary healthcare facilities.展开更多
The use of mesh plug in hernioplasty was introduced by Shulman et al in 1990 as a ＂rolled plug＂ fixed with two stitches to close the internal inguinal ring. Robbins and Rutkow described their mesh plug technique in...The use of mesh plug in hernioplasty was introduced by Shulman et al in 1990 as a ＂rolled plug＂ fixed with two stitches to close the internal inguinal ring. Robbins and Rutkow described their mesh plug technique in 1993. In the following years, this technique and the type and size of plug have been modified deliberately by others. The technique now is commonly used to repair inguinal hernia but complications occur because of migration of mesh plug after open inguinal hernioplasty. We present a case of strangulated bowel obstruction-resulting from migration of mesh plug after open inguinal hernioplasty.展开更多
基金Supported by the Medical Science Research Project of Hebei Provincial Health Commission,No. 20211642Key Research and Development Project of Hebei Province,No.21377773D
文摘BACKGROUND Mesh plug(MP)erosion into the intra-abdominal organs is a rare but serious long-term complication after inguinal hernia repair(IHR),and may lead to aggravation of symptoms if not treated promptly.It is difficult to diagnose MP erosion as there are no obvious specific clinical manifestations,and surgery is often needed for confirmation.In recent years,with the increased understanding of postoperative complications,MP eroding into the intra-abdominal organs has been a cause for concern among surgeons.CASE SUMMARY A 50-year-old man was referred to the Department of General Surgery with the complaint of abdominal pain in the right lower quadrant for 2 d.He had a surgical history of right open IHR and partial thyroidectomy performed 20 years and 15 years ago,respectively.Computed tomography revealed a circinate highdensity image with short segmental thickening of the ileum stuck to the abdominal wall,and no evidence of recurrent inguinal hernia.Laparoscopic abdominal exploration confirmed adhesion of the middle segmental portion of the ileal loop to the right inguinal abdominal wall;the rest of the small intestine was normal.Further exploration revealed migration of the polypropylene MP into the intraperitoneal cavity and formation of granulation tissue around the plug,which eroded the ileum.Partial resection of the ileum,including the MP and end-to-side anastomosis with an anastomat,was performed.CONCLUSION Surgeons should aim to improve their ability to predict patients at high risk for MP erosion after IHR.
文摘Objective:To explore and analyze the clinical efficacy of flat mesh tension-free hernioplasty in the treatment of patients with inguinal hernia.Methods:A total of 60 patients with inguinal hernia were included and equally divided into an observation group(30 cases,flat mesh tension-free hernioplasty)and a control group(30 cases,mesh plug tension-free hernioplasty)based on differences in surgical plans.The visual analog scale(VAS)for postoperative pain,inflammatory markers(C-reactive protein,white blood cell count),and complication rates were compared between the two groups.Results:At 24 and 48 hours postoperatively,the VAS scores in the observation group were significantly lower than those in the control group(P<0.05).At 24 hours postoperatively,the levels of CRP and WBC were also lower in the observation group(P<0.05).The complication rate was slightly lower in the observation group(P>0.05).Conclusion:Flat mesh tension-free hernioplasty for inguinal hernia can alleviate postoperative pain and suppress inflammatory responses,with fewer complications,making it suitable for promotion at primary healthcare facilities.
文摘The use of mesh plug in hernioplasty was introduced by Shulman et al in 1990 as a ＂rolled plug＂ fixed with two stitches to close the internal inguinal ring. Robbins and Rutkow described their mesh plug technique in 1993. In the following years, this technique and the type and size of plug have been modified deliberately by others. The technique now is commonly used to repair inguinal hernia but complications occur because of migration of mesh plug after open inguinal hernioplasty. We present a case of strangulated bowel obstruction-resulting from migration of mesh plug after open inguinal hernioplasty.
