Treatment of mesh infection after tension-free repair of inguinal hernia / 中国医师进修杂志

Objective To analyze the treatment methods of the mesh infection after tension-free repair of inguinal hernia. Methods The clinical data of 6 patients with mesh infection after tension-free repair of inguinal hernia from January 2012 to December 2017 were retrospectively analyzed. The materials of the meshes were standard knitted polypropylene. Transabdominal preperitoneal technique (TAPP) was performed in 1 case, modified Kugel repair was performed in 1 case, and Lichtenstein repair was used in 4 cases. Five patients accepted reoperation, and the infected meshes were removed combined with closed drainage. One patient accepted conservative treatment. Results The patients who received the reoperation all healed and were discharged without perioperative death; the patients were followed up 6 to 40 months (average 19 months), and there were no recurrence patients. The patient with conservative treatment developed incision chronic infectious sinus formation. Conclusions There are many reasons for mesh infection after tension-free repair of inguinal hernia, and the management should be individual. Once the infection occurs, the infected mesh should be removed timely so as to shorten the course of disease, but the key is prevention.

Therapeutic effect compared between laparoscope and open neoplasty of gastroduodenal ulcer perforated / 中国医师进修杂志

Objective To compare the safety and therapeutic effect between laparoscope and open neoplasty of gastroduodenal ulcer perforated.Methods Among 93 patients with gastroduodenal ulcer perforated,54 patients were given laparoscope neoplasty of gastroduodenal ulcer perforated (laparoscope group),39 patients were given open neoplasty of gastroduodenal ulcer perforated (open group).The informations during the period of operation in the 2 groups were compared.Results There was no death in the 2 groups,2 cases in laparoscope group converted to open operation.The operation time of laparoscope group was significantly longer than that of open group [(74.85 ± 15.80) min vs.(62.97 ± 12.14) min],there was statistical difference (P ＜ 0.01).There were no statistical differences in the time of postoperative indwelling gastric tube,hospitalization time and complication rate between the 2 groups (P ＞ 0.05).The rate of postoperative analgesia of laparoscope group was significantly lower than that of open group [20.4％ (11/54) vs.74.4％ (29/39)],there was statistical difference (P ＜ 0.01).Conclusion Laparoscope neoplasty of gastroduodenal ulcer perforated is effective and safe,and has high application value.