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篇名	Nonligation of indirect hernia sac in senior male patients with dilated internal ring
作者	Chih-Jen Huang, Hsien-Pin Sun
卷期/出版年月	46卷3期 (2013/6)
頁次	76-78
摘要	Background: There is a debate about how the indirect hernia sac should be treated in order to prevent hernia recurrence. Recently, nonligation treatment of the indirect hernia sac has been proposed and performed successfully in patients with nondilation of the internal ring. Aims: To evaluate the feasibility of nonligation of the indirect hernia sac among patients with a dilated internal ring. Materials and methods: Data were gathered from January 2005 to August 2008. Patients from two regional hospitals included 117 senior male patients with indirect inguinal hernia and medium or large internal ring orifices. The patients were divided into two groups: a ligation group and a nonligation group. Simultaneous posterior wall reinforcement with Shouldice repair was performed on both groups. Results: In the ligation group, high-ligation of the indirect hernia sacwas performed in 60 patients with 62 hernia repairs. In the nonligation group, nonligation treatment of the hernia sac was performed in 57 patients with 60 hernia repairs. The postoperative pain intensity (p＝ 0.730) and complicationrate (p＝0.560)were similarbetweenthe two groups. After a 3-year followupperiod, six patients (10%) in the ligation group and eight patients (14%) in the nonligation groupwere lost to follow-up. The recurrence rate of indirect hernia was similar in both groups (p ＝0.893). Conclusion: In senior male patients with a dilated internal ring, nonligation treatment of the indirect hernia sac is a safe procedure with no adverse influence on indirect hernia recurrence if a simultaneous posterior wall repair is performed.
關鍵詞	dilated internal ring;indirect hernia sac;ligation;nonligation;Shouldice repair
分類	Original Article