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Mesh plug erosion into the small intestine after inguinal hernia repair: A case report

World Journal of Clinical Cases 2022年第12期10卷 3944-3950页

作者： Tian-Hao Xie Qiang Wang Si-Ning Ha Shu-Jie Cheng Zheng Niu Xiang-Xiang Ren Qian Sun Xiao-Shi Jin Department of General Surgery the Affiliated Hospital of Hebei UniversityBaoding 071000Hebei ProvinceChina

BACKGROUND Mesh plug(MP)erosion into the intra-abdominal organs is a rare but serious long-term complication after inguinal hernia repair(IHR),and may lead to aggravation of symptoms if not treated *** is difficult to diagnose MP erosion as there are no obvious specific clinical manifestations,and surgery is often needed for *** recent years,with the increased understanding of postoperative complications,MP eroding into the intra-abdominal organs has been a cause for concern among *** SUMMARY A 50-year-old man was referred to the Department of General Surgery with the complaint of abdominal pain in the right lower quadrant for 2 *** had a surgical history of right open IHR and partial thyroidectomy performed 20 years and 15 years ago,*** tomography revealed a circinate highdensity image with short segmental thickening of the ileum stuck to the abdominal wall,and no evidence of recurrent inguinal *** abdominal exploration confirmed adhesion of the middle segmental portion of the ileal loop to the right inguinal abdominal wall;the rest of the small intestine was *** exploration revealed migration of the polypropylene MP into the intraperitoneal cavity and formation of granulation tissue around the plug,which eroded the *** resection of the ileum,including the MP and end-to-side anastomosis with an anastomat,was *** Surgeons should aim to improve their ability to predict patients at high risk for MP erosion after IHR.

关键词： Mesh plug inguinal hernia repair Migration Erosion Complication Case report

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Perioperative Local Cooling Reduce Significantly Early Pain after Open inguinal hernia repair:A Prospective Randomized Study

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Pain Studies and Treatment 2014年第3期2卷 113-120页

作者： Gerard Champault Luca Paolino Antonio Valenti Christophe Barrat Department of Digestive and Metabolic Surgery Hopital Jean VerdierBondyFrance Pole de Coeliochirurgie Hopital Joseph DucuingToulouseFrance

Pain and local complications are the major determinants of outcome after inguinal hernia repair. To evaluate the respective impact of peri-operative cooling of surgical site and usual care after open inguinal hernia repair, we performed a prospective randomized study. Methods: One hundred and eight consecutive patients with primary unilateral inguinal hernia were included the study. repair was performed by local direct access during ambulatory surgery. The first study group underwent standard pre- and postoperative local care (control group). In the second group (cold compress group), a single-use disposable sterile cold compress was applied on the surgical site for at least 30 minutes before and 2 hours after surgery. Primary endpoints were immediate postoperative pain using a visual analogue scale, and local complications. Secondary endpoints included: analgesic drug consumption, length of hospital stay, delay to return to normal activity and patient satisfaction. Results: There was no difference concerning operative time (36.3 ± 14.0 vs 39.6 ± 7.2 minutes) and early (one-week) complications, although there was a non significant reduced incidence of hematoma and ecchymosis (0/54 versus 4/54) for the cold compress group. Analgesic drug consumption was significantly (p = 0.01) reduced. During the day of surgery and the first postoperative day, the visual analogue scale was significantly lower after cooling. There was a non-significant reduction in length of hospital stay (150 ± 37 versus 210 ± 47 min), and time to return to normal activity was shorter in the cold compress group. Conclusion: For open inguinal hernia repair, immediate pre- and post operative surgical site cooling, targeting a controlled temperature between 12?C and 15?C significantly reduced postoperative pain, analgesic drug consumption and resulted in improved immediate outcomes. This technique is safe, simple, easy to use, inexpensive and well tolerated by the patient.

关键词： inguinal hernia repair Cooling Ambulatory Surgery Pain Analgesics

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