摘要目的 探讨在局部麻醉下应用前入路置入3DMax补片施行腹股沟疝无张力修补术的可行性及优越性.方法 回顾性分析2008年12月至2010年12月,在局部麻醉下施行的3DMax补片的无张力腹股沟疝修补术30例,对患者手术时间、手术方式、术后镇痛药应用、术后并发症、术后住院天数进行综合分析.结果 30例患者均成功施行局麻下腹膜前3DMax补片置入术,手术时间平均(63.1 ±2.6) min.术后即可进食水,无尿潴留.术后无痛或轻微疼痛患者23例,中度疼痛6例,重度疼痛1例.30例伤口均一期愈合,2例发生皮下淤血,2例发生补片上方少量血清肿,1例患者大腿内侧皮肤感觉麻木,4个月后好转.3例患者下蹲时腹股沟区有异物感,1～5个月后消失.30例患者均获得随访,平均(11±7)个月,无复发.结论 局麻前入路应用3DMax补片覆盖耻骨肌孔修补腹股沟疝是一种安全有效、创伤轻的方法,能提高多发疝的术中诊断,避免遗漏疝的发生.

abstractsObjective To assess Bard3DMax Mesh pre-formed Knitted Polypropylene tension free hernia repair under local anesthesia. Methods Bard 3DMax Mesh was used for inguinal hernia repair in 30 cases under local anesthesia at our department. Results Hernia was successfully repaired in all cases using Bard 3DMax Mesh from the myopectineal orifice through anterior approach under local anesthesia.The mean operation time was (63.1 ± 2.6) min.All cases were able to drink and eat immediately after surgery,there was no postoperative urinary retention.Postoperative pain-free or mild pain was reported in 23 cases,moderate pain in 6,severe pain in only one.Wound healed by first intention in all 30 cases.Two cases suffered from subcutaneous ecchymosis,a seroma above the patch was observed in 2 cases.A inner thigh numb was complained in one case,which subsided 4 months later.Three patients complained below groin area foreign body sensation which disappeared after 1 -5 months. All patients recovered well without recurrence at a mean follow-up of ( 11 ± 7) months. Conclusions Bard 3DMax Mesh tension free inguinal hernia repairing the myopectineal orifice through anterior approach under local anesthesia is safe,and less traumatic.It also helps establish intraoperative diagnosis of combined and occult hernia.