Investigation of prevalence for perioperative venous thromboembolism and risk factors of the present situation in Chinese adults patient with inguinal hernia(CHAT-1) / 中国实用外科杂志

OBJECTIVE: To investigate and analyze the current situation of inguinal hernia treatment and postoperative venous thromboembolism(VTE)events in Chinese adults. METHODS: From January 1, 2017 to December 31, 2017, the patients who were hospitalized with inguinal hernia in 58 large hospitals in mainland China were retrospectively analyzed by means of questionnaire. After data cleaning, all patients were stratified and statistically analyzed using Caprini score.RESULTS: A total of 14 322 questionnaires were received from 58 different hospitals. After data patching and data cleaning, a total of 13 886 questionnaires(97.0%) were retained in accordance with the standard. The ratio of laparoscopic surgery and open surgery was 51.2% and 48.8% respectively. A total of 16 VTE events were observed,accounting for 0.1%(95% CI 0.11-0.13). The incidence of VTE was 0.2%(95%CI 0.18-0.20) in the high-risk group and 0.02%(95%CI 0.01-0.03) in the middle-risk group. The incidence of VTE in the high-risk group was significantly higher than that in the middle-risk group(P=0.000). No VTE event was found in the low-risk group. Of all patients, only 3250(23.4%) underwent Caprini risk assessment,with 13.2% receiving any prevention, whether appropriate or not, and only 1.2% receiving appropriate prevention. CONCLUSION: The incidence of VTE event after operation of inguinal hernia in Chinese adults is severely underestimated, and has not been paid enough attention by surgeons at present.

The problems of mesh repair and the value of tissue repair in the treatment of groin hernia in young people / 中国实用外科杂志

The World Health Organization defines youth as 14 to 25 years old, and the inguinal hernia patients in this age group are still in the development stage of the body with special physiological characteristics and special needs for the protection of reproductive functions. Therefore, the repair method should be carefully selected for the special group and the principle of individualized treatment should be adhered to.The synthetic mesh has problems such as failure to extend with body growth, excessive scar hyperplasia compressing the spermaduct, and long-term invasion. The biological patch also has the risk of long-term recurrence or local bulging. For youth, standard tissue repair surgery can mending the defect well, with reasonable perioperative management, also can minimize the discomfort, which caused by excessive early postoperative tension. At the same time, tissue repair can adapt to the growth of the body, with relatively small impact on reproductive function, or can be combined with biological materials to repair large defects if necessary. After mastering tissue repair technology, the recurrence rate of tissue repair is acceptable. Therefore, tissue repair is of irreplaceable value in the treatment of young inguinal hernia patients.