@article{oai:jichi-ir.repo.nii.ac.jp:00000039, author = {小泉, 大 and 佐田, 尚宏 and 田口, 昌延 and 笠原, 尚哉 and 石黒, 保直 and 遠藤, 和洋 and 笹沼, 英紀 and 佐久間, 康成 and 清水, 敦 and LEFOR, Alan and 安田, 是和}, journal = {自治医科大学紀要, Jichi Medical University Journal}, month = {Mar}, note = {2001年~2011年に施行した大腿ヘルニア手術症例52例を検討した。全例でCT 施行し,大腿ヘルニアの術前診断は41例(CT 正診率80%)だった。嵌頓群は37例(71%)で,イレウス症状は20例(嵌頓群の54%)で認め,全例緊急手術を要した。ヘルニア内容は小腸27例(73%)が最も多かった。腸切除は16例(43%)で施行した。発症から手術までの経過時間は,切除群と非切除群で平均値は同等で有意差を認めなかった(P=0.621)。後壁補強は McVay 法が37例(95%)で施行され,非嵌頓群では各種メッシュ法が53%で選択されていた。術後合併症は嵌頓群で有意に多かったが,腸切除の有無では有意差を認めなかった。腸切除を避けるためには,早期診断・治療が必要であり,発症からできるだけ早いタイミングでの介入が有効と考えられた。, [Aim] Determine the outcome of surgical evaluation of femoral hernias.[Methods] From 2001 to 2011, 52 patients were retrospectively evaluated according to clinical manifestations.[ Results] Before surgery, 41 patients( 80%) were accurately diagnosed by computed tomography. 35 of 37 incarcerated patients( 95%) and 6 of 15 non-incarcerated patients( 40%) were accurately diagnosed by CT scan. 19 of 21 resected patients( 90%) and all non-resected patients( 100%) were accurately diagnosed. Emergent surgery was performed for 37( 71%) patients having incarceration and 20 having bowel obstruction( 54% of those with incarceration). The hernial sac contained small intestine in 27( 73%) cases. Intestinal resection was performed for 16 patients( 43%), and McVay repair for 37 patients, 95% of whom had incarceration. Mesh repair was performed in 53% of the patients without incarceration. Average time from onset of symptoms to surgery did not differ significantly between the intestinal resection and non-resection groups( P=0.621). Postoperative complications were significantly more common in incarcerated patients, but were not significantly different when comparing the resection and non-resection groups.[ Conclusions] To avoid the need for intestinal resection, early diagnosis and treatment is needed. Surgery should be performed as early as possible after the onset of symptoms.}, pages = {87--91}, title = {大腿ヘルニア手術症例の臨床的検討}, volume = {35}, year = {2013} }