完全腹膜外腹腔镜腹股沟疝修补术的临床应用体会  

Clinical application of totally extraperitoneal laparoscopic herniorrhaphy

作　　者：路夷平[1] 张能维[1] 合比尔[2] 李凯[1] 王桐生[1] 刘晨[1] 

机构地区：[1]北京世纪坛医院外科,100038 [2]和田地区人民医院外三科,新疆848000

出　　处：《中华疝和腹壁外科杂志（电子版）》2009年第4期11-14,共4页Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition)

摘　　要：目的总结完全腹膜外腹腔镜疝修补术(TEP)的成功经验。探讨TEP手术的安全性、可行性、有效性及手术方法。方法回顾分析2006年10月至2008年5月我们收治的125例(145例次)腹股沟疝患者行TEP手术的临床资料。直疝25例次,斜疝111例次,复合疝9例次;单侧疝105例,双侧疝20例;其中复发疝11例。结果125例患者共行145例次TEP手术。手术时间30～182min(平均单侧48min,双侧106min)。术后使用镇痛剂4例。住院时间2～8d,平均3±1.2d。主要并发症为阴囊血清肿或血肿10例,术后尿潴留11例,腹股沟区疼痛4例,膀胱损伤1例。随访3～20个月,术后复发1例,为早期手术病例。结论TEP手术具有安全可靠、术后疼痛轻、恢复快、术后疼痛发生少、远期舒适性好、复发率低等优势,应成为腹腔镜治疗腹股沟疝的主要术式。Objective To study and summarize the successful experience,the safety,the feasibility, the practicality and operation skills of totally extraperitoneal laparoscopic herniorrhaphy （TEP）. Methods Between October 2006 and May 2008,125 patients were performed（ 145 totally extraperitoneal laparoscopic hernia repairs for inguinal hernia）. Including 25 direct inguinal hernias, 111 indirect inguinal hernias and 9 complex inguinal hernias. Among 125 patients, 105 patients hacl unilateral hernia and 20 patients had bilateral hernias, including 11 recurrent hernias. Results The operations were lasted for 30 to 182 minutes （ the mean operating duration was 48 minutes for unilateral hernia and 106 minutes for bilateral hernia）. There were 4 patients need analgesics. The patients stayed in hospital for 2 to 8 days（ the mean inpatient hospital stay was 3 ＋ I. 2 days）. The mostly complications were scrotum hematomas or seromas ,which appeared in 10 cases. Urinary retention appeared in 11 cases. Bladder injury appeared in 1 case. Inguinal pain appeared in 4 cases. All the patients were followed up for 3 to20 months. There was only 1 case of recurrence,which was operated early in our group. Conclusions The procedure of TEP is safe, with faster postoperative recover, less pain, lower incidence of pain, better comfort quality and lower recurrence rate. TEP should be the main laparoscopic procedure for inguinal hernia repair.

关 键 词：疝 腹股沟 腹腔镜 疝修补术 

分 类 号：R656.2[医药卫生—外科学]