腹腔镜完全腹膜化腹腔内置片修补腹股沟疝  

Laparoscopic placement of total peritoneum intraperitoneal onlay mesh in patients with inguinal hernia

作　　者：向国安[1] 陈开运[1] 王汉宁[1] 肖方联[1] 

机构地区：[1]广东省第二人民医院普外科,广东广州510317

出　　处：《南方医科大学学报》2009年第3期504-505,508,共3页Journal of Southern Medical University

基　　金：广东省医学科技基金(A2007144)

摘　　要：目的探讨腹腔镜完全腹膜化腹腔内置片法治疗腹股沟疝的有效性及优越性。方法2002年1月～2004年1月应用腹腔镜完全腹膜化腹腔内补网片法(TPIPOM)治疗125例腹股沟疝(其中嵌顿疝32例,双侧疝44例,复发疝26例),观察手术后恢复情况及随访结果,并与64例行腹腔腹膜前网片腹腔镜疝修补术(TAPP)和53例全腹膜外疝修补手术(TEP)治疗腹股沟疝的结果相比较。结果所有手术均在腹腔镜下完成。手术时间(min):TPIPOM组、TAPP组、TEP组分别为30.8±10.3、68.4±22.4、和69.5±23.4(P<0.05);住院时间(d):TPIPOM组、TAPP组、TEP组分别为3.8±1.3、4.3±1.5和4.5±1.6(P<0.05);下床时间(d):TPIPOM组、TAPP组、TEP组分别为1.2±0.5、1.8±0.7和2.2±0.8(P<0.05);术后疼痛持续时间(d):TPIPOM组、TAPP组、TEP组分别为1.0±0.5、1.6±0.9和1.9±0.8(P<0.05);住院费用(元):TPIPOM组、TAPP组、TEP组分别为5000.8±800.5、8000.5±950.6和8900.2±750.3(P<0.05)。三组均未发现阴囊水肿。所有病例随访(59.9±6.5)月,各组病例均无复发。结论TPIPOM治疗腹股沟疝安全可行,且创伤小、恢复快、住院时间短、费用少,不易复发,无肠梗阻等并发症。Objective To study the efficacy of laparoscopic placement of total peritoneum intraperitoneal onlay mesh （TPIPOM） for treatment of inguinal hernia. Methods TPIPOM was placed laparoscopically in 125 cases of inguinal hernia, and the clinical outcomes of the patients were observed and compared with 64 patients receiving transabdominal preperitoneal laparoscopic mesh repair （TAPP） and 53 with total extraperitoneal laparoscopic hernioplasty （TEP）. Results The laparoscopic operations were successfully performed in all the patients. In TPIPOM, TAPP and TEP groups, the operating time was 30.8± 10.3 min, 68.4±22.4 min and 69.5±23.4 min （P〈0.05）, the mean hospital stay was 3.8±1.3 days, 4.3±1.5 days and 4.5±1.6 days （P〈0.05）, the average time to ambulation was 1.2±0.5 days, 1.8±0.7 days and 2.2±0.8 days （P〈0.05）, the duration of pain was 1.0±0.5 days, 1.6±0.9 days and 1.9±0.8 days （P〈0.05）, and the cost was 5000.8±800.5 yuan, 8000.5±950.6 yuan and 8900.2± 750.3 yuan （P〈0.05）, respectively. No scrotum edema occurred in these patients. The patients were followed up for 59.9±6.5 months and recurrence was found. Conclusion TPIPOM is safe and effective for management of inguinal hernia with such advantages as minimal invasion, simple procedures, shorter operation time, reduced relapse and quick recovery.

关 键 词：腹股沟疝 腹腔镜 完全腹膜化腹腔内置片法 

分 类 号：R656.2[医药卫生—外科学]