以日间手术模式开展单孔腹腔镜完全腹膜外腹股沟疝修补术的实践  

The practice of single incision TEP inguinal hernia repair in day surgery mode

作　　者：陈德键 缪传文[1] 傅晟静 顾春红 刘斌 Dejian Chen;Chuanwen Miao;Chengjing Fu;Chunhong Gu;Bin Liu(Department of Day Care(Hernia Center),Shanghai General Hospital Affiliated to Shanghai Jiao Tong University School of Medicine,Shanghai 201600,China)

机构地区：[1]上海交通大学医学院附属第一人民医院日间医疗部(疝中心),201600

出　　处：《中华疝和腹壁外科杂志（电子版）》2022年第6期699-703,共5页Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition)

摘　　要：目的探讨以日间手术模式开展腹股沟疝单孔腹腔镜完全腹膜外疝修补术(SIL-TEP)的合理性、安全性与有效性。方法回顾性分析2020年3月至2021年2月上海交通大学医学院附属第一人民医院行腹股沟疝TEP日间手术363例患者资料,其中行SIL-TEP手术120例(单孔组),传统三孔TEP手术243例(三孔组)。观察围手术期及随访期指标,进行组间对比分析。结果2组患者均在日间手术模式下顺利完成手术并出院,均无延期出院及转科病例。2组患者的年龄、性别构成、体质量指数、疝分类部位、手术时间差异无统计学意义。单孔组1例中转三孔TEP,三孔组无中转病例。单孔组术后4 h、1 d疼痛视觉模拟评分低于三孔组,术后下床时间早于三孔组,差异有统计学意义(P<0.05),术后2周及4周恢复非限制活动率相当(P>0.05)。中位随访时间9(4~15)个月,随访率98.6%。术后并发症为尿潴留、血肿、血清肿,2组比较差异无统计学意义(P>0.05),2组均无复发病例且无严重并发症发生。结论以日间手术模式开展SIL-TEP手术是安全、可靠、可行的。Objective To explore the rationality,safety and effectiveness of single incision laparoscopic totally extra-peritoneal hernia repair(SIL-TEP)for inguinal hernia in day surgery mode.Methods To retrospectively analyze the data of 363 patients who underwent inguinal hernia TEP day surgery from March 2020 to February 2021 in the Shanghai General Hospital Affiliated to Shanghai Jiao Tong University School of Medicine.Among them,120 patients underwent SIL-TEP surgery(single-incision group)and 243 cases underwent conventional TEP surgery(three-port group).Indicators in the perioperative period and follow-up period were observed and compared between the two groups.Results All patients in the two groups successfully completed in day surgery mode and discharged on schedule.There was no delayed discharge or department transference.There was no significant difference in age,gender composition,BMI,hernia type and location,operation time between the two groups.One case in the single-incision group was transferred to the traditional three-port TEP,and there was no transfer case in the three-port group.The visual analogue scale(VAS)of pain in the single-incision group was lower than that in the three-port group at 4 hours and 1 day after the surgery,and the time to get out of bed was shorter in the single-incision group than that in the three-port group,the difference was statistically significant(P<0.05).The rate of unrestricted activity recovery was similar at 2 and 4 weeks after surgery(P>0.05).The median follow-up time was 9(4~15)months,and the follow-up rate was 98.6%.The postoperative complications were urinary retention,hematoma and seroma,and there was no significant difference between the two groups(P>0.05).There were no recurrence case and no serious complication in the two groups.Conclusion It is safe,reliable and feasible to carry out SIL-TEP surgery in day surgery mode.

关 键 词：日间手术 疝 腹股沟 腹腔镜 疝修补术 

分 类 号：R65[医药卫生—外科学]