Safa ÖNEL, Faruk KARATEKE, Sefa ÖZYAZICI, Ebru MENEKŞE, Adnan KUVVETLİ, Mehmet ÖZDOĞAN

Kompleks Kasık Fıtıklarının Onarımında Uygulanan Anterior Preperitoneal Yaklaşım

Amaç : Kasık fıtıklarının tamirinde altın standart Lichtenstein onarımıdır. Ancak nüks, dev, femoral veya kombine fıtıklar gibi kompleks fıtıkların varlığında farklı yaklaşımlar gerekir. Bu çalışmada kompleks fıtıkların tamirinde uyguladığımız anterior preperitoneal yaklaşımlı fıtık onarımı tekniğimizi sunmayı amaçladık. Materyal ve Metod: Bu çalışma Ocak 2001 ile Ağustos 2011 yılları arasında yapıldı. Çalışmaya nüks kasık fıtığı, dev inguino-skrotal, femoral veya kombine fıtığı olan hastalar dahil edildi. Hastaların demografik özellikleri, fıtık tipleri, ameliyat süreleri, ameliyat sonrası erken ve geç dönem takip sonuçları kaydedildi. Bulgular: Çalışma periyodunda 32"si erkek, 8"i kadın olmak üzere toplam 40 hastaya ameliyat tekniğimizle fıtık onarımı yapıldı. Ortalama yaş (±SS) 44±6.8 idi. Dört hastada dev direkt, 12 hastada dev inguino-skrotal fıtık, 14 hastada nüks kasık fıtığı ve 10 hastada femoral fıtık mevcuttu. 4 hasta acil şartlarda inkarserasyon nedeniyle ameliyat edildi. Ortalama ameliyat süresi (±SS) 61±11dk. idi. Ortalama 7±2.2 yıllık takip süresince hiçbir hastada nüks saptanmadı. Sonuç: Ameliyat tekniğimizde tek parça prolen yama ile myopektineal açıklıktaki olası tüm defektler kapatılarak tüm fıtık tipleri onarılabilir.

Anahtar Kelimeler:

Kasık fıtığı; Femoral fıtık; Nüks kasık fıtığı; Lichtenstein tekniği.

The Anterior Preperitoneal Approach for Repair of Complex Inguinal Hernias

Purpose: The gold standard for the repair of inguinal hernias is the Lichtenstein repair. However, complex inguinal hernias such as recurrent hernias, giant hernias, femoral hernias or combined hernias are present, it is necessary to choose different approaches. In this study, we aimed to present how we repair complex hernias using our open anterior preperitoneal technique. Material and Methods: The present study was carried out between the period from January 2001 through August 2011. The patients with recurrent inguinal hernia, giant inguino-scrotal, femoral or combined hernias were included. The demographics, hernia types, operation time, postoperative early and long term follow-up outcomes were recorded. Results: A total of 40 patients (Male:32, Female:8) underwent hernia repair with our technique during the study period. The mean age was (±SD) 44±6.8 years. Four patients had giant direct hernia,12 patients had giant inguino-scrotal hernia, 14 patients had recurrent and 10 patients had femoral hernia. 4 patients were underwent emergent surgery due to incarceration. The mean operation time was (±SD) 61±11 min. There was no recurrence with the mean follow-up time of 7±2.2 years. Cnclusion: Our surgical technique allows to repair all types of inguinal hernia with one piece of prolene mesh by covering all potential defects.

Keywords:

Inguinal hernia; Femoral hernia; Recurrent inguinal hernia; Lichtenstein tecnique,

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Yazışma Adresi / Address for Correspondence: Dr. Faruk Karateke Adana Nu mune Eğitim ve Araştırma Hastanesi Genel Cerrahi Kliniği ADANA E-mail: karatekefaruk@hotmail.com G eliş tarihi/Received on : 05.06.2014
Kabul tarihi/Accepted on: 30.05.2014