AMYAND'S HERNIA; CASE SERIES AND OUR TEN YEARS EXPERIENCE. Amyand f?t???; olgu serisi ve 10 y?ll?k deneyimimiz.

摘要

We aim to share our clinic experience with Amyand's hernia, which is rare condition and has ongoing discussion about it's treatment. The files of patients with Amyand's hernia during the last ten years were reviewed retrospectively. The patients' demographic characteristics, diagnosis, treatment and early complications were assessed. Amyand's hernia was found on seven patients. All patients were male and mean age was 42. Four patients were operated with a diagnosis of strangulated right inguinal hernia, while others were undergoing elective surgery. One patient also had ileus. Inflamed appendix was viewed in two patients and normal appendix was viewed in five patients. All patients underwent appendectomy via hernia incision. Hernia have been treated with prolene mesh in four patients, using the method of darning in one patient and anatomical repair method in two patients. None of patients was observed early complications. Amyand's hernia especially has ongoing discussion in terms of treatment approach (appendectomy? or mesh application?). These cases are rare and diagnosed usually intraoperatively. The appropriate treatment approach in these cases such as performed appendectomy or not, should be decided according to the surgeon's intraoperative findings. In cases with appendicitis, hernia repair should be tought with anatomic repair, the method of darning or using biological materials resistant to infection along with using prosthetic materials. ? ?ZET Bu yaz?da, nadir g?rülen ve tedavi yakla??m? a??s?ndan tart??malar?n devam etti?i Amyand f?t??? ile ilgili tecrübelerimizi payla?may? ama?lad?k. Son on y?lda Amyand f?t??? tan?s? alan hastalar?n dosyalar? retrospektif olarak incelenerek, demografik ?zellikler, tan?, tedavi ve erken d?nem komplikasyonlar a??s?ndan de?erlendirmeler yap?ld?. Toplam 7 hastada Amyand f?t??? saptand?. Hepsi erkek olan hastalar?n ya? ortalamas? 42 olarak saptand?. Hastalardan 4'ü inkarsere sa? inguinal f?t?k tan?s?yla, di?erleri ise elektif ?artlarda ameliyat edildi. Bir hastada ayn? zamanda ileus tablosu mevcuttu. ?ki hastada apendiks vermiformis inflame iken, 5 hastada normal olarak izlendi. Tüm hastalara f?t?k kesisinden apendektomi uyguland?. F?t?k 4 hastada prolen yama kullan?larak, 1 hastada a? ?rme y?ntemiyle ve 2 hastada anatomik tamir y?ntemiyle (yamas?z onar?m) tedavi edilmi?ti. Hastalar?n hi?birinde erken d?nem komplikasyon izlenmedi. Amyand f?t??? ?zellikle tedavi yakla??m? a??s?ndan (apendektomi? yama uygulamas??) tart??malar?n devam etti?i nadir g?rülen ve genellikle ameliyat s?ras?nda tan? konulabilen olgulard?r. Bu olgularda cerrah, uygun tedavi yakla??m?na, ameliyat s?ras?ndaki bulgulara g?re karar vermelidir. Apandisit bulgular?n?n e?lik etti?i olgularda; prostetik materyaller kullanman?n yan? s?ra, anatomik tamir (yamas?z onar?m), a? ?rme y?ntemi veya enfeksiyona diren?li biyolojik materyallerle f?t?k tamiri y?ntemlerinin de kullan?labilece?i ak?lda bulundurulmal?d?r.