关键词: 嵌顿疝, 急诊手术, 腹腔镜, 疗效分析

Abstract: Selection and analysis of therapeutic effects of emergency surgical procedures for incarcerated inguinal hernia (report of 497 cases in a single center over 10 years)        LI Shao-jie, LI Shao-chun, SU Yuan-tao, et al.  Department of General Surgery, Huadong Hospital Affiliated to Fudan University, Hernia and Abdominal Wall Diseases Treatment Center， Shanghai 200040, China
Corresponding author： TANG Jian-xiong，E-mail:johnxiong@china.com
Abstract    Objective    To explore the selection and therapeutic effects of emergency surgical procedures for incarcerated inguinal hernia. Methods    A retrospective analysis was conducted on the case data of 497 emergency surgical treatment patients admitted to the General Surgery Department of Huadong Hospital from Jan. 2013 to Dec. 2022. Including 351 males and 146 females; the Average age was 74.1 (19-103) years old. Among them, 61 cases underwent open tissue repair, 269 cases underwent open mesh repair, and 167 cases underwent TAPP surgery. Pearson chi-square test was used to analyze the correlation between the efficacy of open mesh repair and TAPP.  Results    Among the 497 patients，444 were found to have embedded structures in the small intestine，51 in the colon，1 in the appendix， and 1 in the ovarian appendage and 27 cases were associated with omental tissue.59 cases（11.9%）had short-term postoperative complications， including 25 cases of seroma，21 cases of infection，2 cases of urinary retention，5 cases of intestinal obstruction，2 cases of intestinal fistula， and 4 cases of hematoma； There were 88 cases（17.7%）of delayed postoperative complications， including 27 cases of recurrence，36 cases of SSI，19 cases of seroma，5 cases of chronic pain， and 1 case of mesh infection. Seven patients underwent secondary surgery due to postoperative complications（2 cases of intestinal fistula，4 cases of incision infection，and 1 case of hematoma）. The incidence of mortality rate and complication rate in patients with strangulated hernia were significantly higher than in the incarcerated ones. The efficacy of TAPP and open mesh repair was similar， and the incidence of postoperative SSI was statistically lower in the TAPP group. There was no difference in other complications between the two groups. Conclusion    Emergency surgery for incarcerated inguinal hernia requires a reasonable selection of surgical methods based on the blood supply of the hernia content. In the absence of strangulation， TAPP has a definite therapeutic effect， a similar incidence of complications to open mesh repair， and a shorter postoperative recovery time. It can be the preferred surgical method for patients who tolerate general anesthesia.

Key words:  , incarcerated hernia； emergency surgery； laparoscopy； efficacy analysis