完全腹膜外腹腔镜腹股沟疝修补术的临床应用  

Clinical application of totally laparoscopic extraperitoneal herniorrhaphy

作　　者：路夷平[1] 姚琪远[2] 张能维[1] 李凯[1] 王桐生[1] 刘晨[1] 

机构地区：[1]北京世纪坛医院外科,北京100038 [2]上海复旦大学华山医院外科,上海200040

出　　处：《国际外科学杂志》2009年第12期815-818,共4页International Journal of Surgery

摘　　要：目的总结完全腹膜外腹腔镜疝修补术（totally extraperitoneal prosthetic，TEP）的成功经验。探讨TEP手术方法及手术优势。方法回顾分析2006年10月～2008年5月北京世纪坛医院外科和上海复旦大学华山医院外科收治的225例（265侧次）腹股沟疝患者行TEP手术的临床资料。直疝55侧次，斜疝197侧次，复合疝13侧次；单侧疝185例，双侧疝40例；其中复发疝29侧次。结果225例患者共行265侧次TEP手术。手术时间30～182min（平均单侧48min，双侧106min）。住院时间2—8d，平均（3．0±1．2）d。并发症情况：阴囊血清肿18例，尿潴留21例，腹股沟区疼痛5例，膀胱损伤1例。随访3月～3年，复发1例。结论TEP手术安全可靠、具有术后疼痛发生少、远期舒适性好、复发率低和经济性好等优势，可成为腹腔镜治疗腹股沟疝的主要术式。Objective To study and summarize the successful experience and the safety, easibility, practicality and operation skills of totally laparoscopic extraperitoneal herniorrhaphy （TEP）. Methods From October 2006 to May 2008,225 patients in our two hospitals were performed TEP （ 265 totally laparoscopic extraperitoneal hernia repairs for inguinal hernia）, including 55 direct inguinal hernia, 197 indirect inguinal hernia and 13 complex inguinal hernia operations. Among the 225 patients, 185 patients had unilateral hernia and 40 patients had bilateral hernias, including 29 recurrent hernia. Results The operations were lasted for 30 to 182 minutes（ the average operating duration was 48 minutes for unilateral hernia and 106 minutes for bilateral hernia）. The patients stayed in hospital for 2 to 8 days（ the average inpatient hospital stay was 3. 0 ± 1.2 days）. The most common complication was scrotum bematomas,which appeared in 18 cases. Urinary retention appeared in 21 cases. Inguinal pain appeared in 5 cases. Bladder injury appeared 1 case. All the patients were followed up for 3 months - 3 years. There was only 1 case of recurrence. 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：腹腔镜 腹股沟疝 疝修补术 

分 类 号：R656.21[医药卫生—外科学] R683.42[医药卫生—临床医学]