腹腔镜治疗腹股沟疝的手术技巧和临床疗效分析  

Analysis of Surgical Technique and Clinical Outcome of Laparoscopic Inguinal Hernia Repair

作　　者：曾辉[1] 李锋[1] 

机构地区：[1]四川省德阳市人民医院普外科,德阳618000

出　　处：《中国普外基础与临床杂志》2009年第2期98-101,共4页Chinese Journal of Bases and Clinics In General Surgery

摘　　要：目的探讨经腹腹膜前补片植入术(TAPP)和全腹膜外补片植入术(TEP)治疗腹股沟疝的手术技巧和临床效果。方法回顾分析2007年7月至2008年10月期间我院实施腹腔镜腹股沟疝修补术23例(26侧)患者的临床资料,其中TAPP9例(10侧),TEP14例(16侧)。结果无一例中转为开放手术。1例TEP转行TAPP。平均手术时间(82.1±40.6)min,术中出血量(5.7±3.0)ml;TEP术中腹膜撕裂2例。术后并发症发生率为21.7%(5/23),其中术后血清肿1例,阴囊气肿2例,修补区暂时性神经感觉异常1例,尿潴留1例;术后未出现慢性、持续性神经性疼痛、异物感,补片感染和切口感染。术后平均住院时间(4.3±0.9)d。术后随访1～15个月,平均(7.2±2.3)个月,无其他不适及复发病例。结论腹腔镜腹股沟疝修补术安全、复发率低、并发症少、痛苦轻、住院时间短、恢复快。Objective To explore surgical technique and clinical outcome of transabdominal preperitoneal hernia repair （TAPP） and totally extraperitoneal hernia repair （TEP） in inguinal hernia repair. Methods The clinical data of 23 patients underwent laparoscopic herniorrhaphy were retrospectively analyzed. Nine patients were underwent TAPP, and 14 patients underwent TEP. Results None of patients was changed to open operation. Only one patient of TEP was changed to TAPP. Average operative time was （82.1±40.6） min. Blood loss was （5.7±3.0） ml. Disruption of peritoneum happened to 2 patients underwent TEP. The rate of postoperative complications was 21.7% （5/23）, which included serum swelling （1 case）, scrotal emphysema （2 cases）, transient neurapraxia in the area of repair （1 case） and urinary retention （1 case）. No chronic pain, foreign body sensation and infection were found. Average hospitalization after operation was （4.3 ± 0.9） d. No recurrence was observed during a follow-up period of 1-15 months. Conclusion Laparoscope herniorrhaphy is safe due to lower recurrence and complications. It also has the advantages of slight pain and rapid recovery.

关 键 词：疝 腹股沟 腹腔镜 手术 

分 类 号：R656.21[医药卫生—外科学]