多中心，平片（ Lichtenstein 方法） 6 ， 764 例无张力疝修补体验

A multi-center experience with 6,764 Lichtenstein tension-free hernioplasties

Amid PK, Friis E, Horeyseck, Kux M. Hernia 1999;3(S12):47

Introduction : 介绍：

This article reports the outcome measures of the Lichtenstein open tension-free hernioplasty by four principle investigators from four institutions.  Investigators are from two universities and two private practice settings.  The concept of tension-free repair is based on: (a) the degenerative origin of inguinal hernia which results in destruction of the inguinal floor, (b) the fact that the traditional tissue repair is associated with undue tension at the suture line.

本文报道四家医院的四名调查医生应用平片（ Lichtenstein 方式）进行无张力疝修补的结果。四名医生当中，两名分别来自于两所大学的医学院附属医院，另两名分别来自于两家私立医院。无张力疝修补的概念基于以下两点：（ a ）腹股沟疝引起组织退变而导致腹股沟管后壁缺损，（ b ）传统的组织与组织缝合手术在缝线处造成不适当的张力。

Method: 方法：

The procedure, which is performed under local anesthesia, administered in a simple four-step technique, consists of reinforcement of the inguinal floor by an adequately large sheet of prosthesis, which provides sufficient tissue/mesh interface beyond the floor.  As a result, the entire inguinal floor is completely and permanently protected from all future mechanical or degenerative adverse effects.  Therefore, the operation has a dual effect, therapeutic and prophylactic. 

该手术在局麻下，分四个简单步骤进行，用大小适当的网片加强腹股沟管后壁。大小适当的网片延伸至腹股沟管以外，以提供足够网片与组织融合之界面。由此，整个腹股沟管再不会受到将来退变性或机械性的影响而被全面地，永久性地保护起来。

Results: 结果：

6,764 patients were operated for repair of primary inguinal hernias at four different institutions.  Patient demographic relative to age, weight, type of hernia, and operative time are summarized in Table I, and the results listed in Table II.

四家医院共完成原发性无张力疝修补手术 6764 例。病人根据年龄，体重，疝的类型和手术时间归纳于表 I 。手术结果归纳于表 II 。

Conclusion: 结论：

Use of the tension-free technique in conjunction with local anesthesia has drastically reduced the hospital stay, postoperative discomfort, recovery period, recurrence rate and the cost of hernia surgery.  Open "tension-free" hernioplasty is simple and safe, requiring no special expertise for achieving all the goals of modern surgery, with a recurrence rate of 0.1% to 0.9%.

局麻下进行无张力疝修补术大大减少了住院时间，术后不适，恢复时间，复发率以及手术费用。开放式，无张力疝修补术简单，安全，不需要特别专门的技术。复发率 0.1% － 0.9% 。

Table I 表 I

Table II 表 II