Prevention and treatment of vascular complications of inguinal hernia repair / 中华消化外科杂志

ABSTRACT

Objective To explore the prevention and treatment of complications of vascular injury after inguinal hernia repair.Methods The retrospective cross-sectional and descriptive study was adopted.The clinical data of 22 patients with vascular injury after inguinal hernia repair who were admitted to the First Affiliated Hospital of Chongqing Medical University between June 2005 and March 2016 were collected.Observation indicators included(1) the vascular complications after inguinal hernia repairvascular injury,peritoneal interstitial hemorrhage or hematoma formation,thrombosis and vascular embolization,(2) treatment,(3) follow-up.Patients were followed up by telephone interview at 15 days after discharge up to April 2016,and conditions of patients,recovery of symptoms and subsequent pharmacotherapy were detected.Results (1) The vascular complications after inguinal hernia repairof 22 patients,peritoneal interstitial hemorrhage or hematoma formation was detected in 8 patients (vascular injury of corona mortis in 2 patients,inferior epigastric artery injury in 3 patients and unexplained peritoneal interstitial hemorrhage in 3 patients),femoral vein injury in 3 patients,femoral artery injury in 1 patient,deep vein thrombosis of the double lower limbs in 8 patients (including 2 with pulmonary embolism) and femoral and popliteal artery embolism in 2 patients.(2) Treatments20 of 22 patients had good therapeutic effect,1 patient with arterial embolism received timely treatment avoiding the necrosis of limbs,1 ischemic necrosis of partial toes and the other patients had good effect through vascular repair or construction.One patient with inferior epigastric artery injury and 1 with femoral vein injury died of hemorrhagic shock.(3) Follow-up20 of 22 patients were followed up for 2 weeks,with good conditions.Patients' hemorrhage had been improved.The symptoms of patients with deep vein thrombosis and arterial embolism of lower limbs didn't become obviously aggravated,and they took the medicine as medical advice.Conclusion The different treatments are conducted according to the occuring characteristics of vascular complications,with better outcomes.