完全腹膜外腹腔镜疝修补术治疗腹股沟疝(附338例次报告)  

The clinical experience of totally laparoscopic extraperitoneal herniorrhaphy (a report of 338 cases)

作　　者：刘祖军[1] 卢榜裕[1] 蔡小勇[1] 陆文奇[1] 江文枢[1] 

机构地区：[1]广西医科大学第一附属医院微创外科,南宁市530021

出　　处：《微创医学》2008年第5期430-432,共3页Journal of Minimally Invasive Medicine

基　　金：广西壮族自治区卫生厅立项课题(Z2006033)

摘　　要：目的总结我科腹腔镜完全腹膜外腹股沟疝修补术338例次的经验教训。方法292例病人共行338例次腹腔镜完全腹膜外腹股沟疝修补术,直疝57例次,斜疝281例次,单侧疝246例,双侧疝46例,其中复发疝42例。结果中转经腹腔腹膜前修补6例次,完全腹膜外手术成功率98.23%。手术时间25～220min,平均手术时间单侧60min,双侧96min。住院时间4～16d,平均7d。主要并发症为阴囊血清肿或血肿29例(9.93%),术后腹股沟区慢性疼痛4例(1.37%),手术大出血1例,膀胱损伤1例。无手术死亡。随访6个月～5年,术后复发1例。结论腹腔镜完全腹膜外腹股沟疝修补术手术安全,复发率低。掌握手术技巧可提高手术成功率、降低术后并发症和复发率。Objective To conclude clinical experience of totally laparoscopic extraperitoneal hemiorrhaphy of 338 cases. Methods A retrospective study was carried out on 292 patients with inguinal hernia who were performed 338 totally laparoscopic extraperitoneal hemiorrhaphy between October 2002 and May 2007. The chnical data of these patients was analyzed. 292 patients who were 18 -91 ages （the average age was 54） were performed 338 totally laparoseopic extraperitoneal hemiorrhaphy,including 57 direct hernia and 281 indirect hernia operations. Among 292 patients,246 cases had unilateral hernia and 46 cases had bilateral hernia, including 42 recurrent hernia. Results The rate of successful operation was 98.23%. The operation lasted 25 -220min. The average operating duration was 60min for unilateral hernia and 96min for bilateral hernia. The patients stayed in hospital for 4 - 16d without needing of analgesics. The average inpatient hospital stay was 7d. The mostly complications were scrotum hematoma or seroma, which appeared in 29 cases （9.93%） , and the chronic inguinal pain after operation appeared in 4 cases （ 1.37% ） , one case had bladder injury. There was only 1 case of recurrence, 1 case of surgical bleeding,no operative deaths. All the patients were followed up for 6 -60months. Conclusion Laparoscopic totally extraperitoneal inguinal hernia repair surgery was safe, low recurrence rate. To master surgical skills could improve the success rate and reduce postoperative complications and recurrence rate.

关 键 词：腹腔镜 腹股沟疝 疝修补术 

分 类 号：R656.21[医药卫生—外科学]