腹股沟疝假体修复术后再手术的问题。

R Stoppa, B Diarra, P Verhaeghe, X Henry
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引用次数: 0

摘要

这些修复的简单性能和效率应该使外科医生注意到一些相关的缺陷,这些缺陷在再次手术膀胱或前列腺时几乎不会出现,也不会出现在髂血管上。遇到的困难与瘢痕硬化或多或少广泛和/或有效有关,侵入Retzius和/或Bogros的空间。作者报告了他们的术中和解剖结果。他们提出了以下解决方案:(1)当Retzius间隙无法切割时(用于膀胱或前列腺手术):骨膜下耻骨后切割,单独或联合经腹膜入路。(2)当不能切开Bogros间隙时(髂血管手术):经腹膜入路;但预防使用大型假体后血管周围硬化依赖于容易保存的索鞘,能够保护髂血管,前提是没有在网状假体上做切口。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
[Problems of reoperation after prosthetic repair of groin hernia].

The easy performance and the efficiency of these repairs should make the surgeon attentive to some related drawbacks, which can scarcely appear when reoperating on the bladder or the prostate, also on the iliac vessels. The encountered difficulties are related to the scar sclerosis much or less extensive and/or effective, invading the Retzius and/or the Bogros' spaces. The authors report their intraoperative and anatomical findings. They propose the following solutions: (1) when the cleavage of the Retzius' space is impossible (for bladder or prostate surgery): a subperiosteal retropubic cleavage, either isolated or combined with a transperitoneal approach. (2) When the cleavage of the Bogros' space is impossible (for a surgery on the iliac vessels): a transperitoneal approach; but the prevention of the perivascular sclerosis after the use of large prostheses relies on the easy preservation of the funicular sheath, able to protect the iliac vessels, providing no slit has been done on the mesh prosthesis.

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