脐襞在成人腹股沟疝腹腔镜修补术中应用的临床研究  

Clinical research on application of navel crenulation in laparoscopic adult herniorrhaphy

作　　者：李鹏胜[1] 王汉宁[1] 向国安[1] 陈开运[1] 高鹏[1] 肖方联[1] 肖金丰[1] 余智涛[1] 

机构地区：[1]广东省第二人民医院普外科微创中心,广东广州510317

出　　处：《中国内镜杂志》2012年第2期154-156,共3页China Journal of Endoscopy

基　　金：广东省医学科研课题基金(No.A2007144)

摘　　要：目的探讨脐襞(脐正中襞或脐内侧襞)在成人腹股沟疝腹腔镜修补术中应用的可行性、优越性。方法 2003年1月～2008年6月,该科开展成人腹股沟疝腹腔镜完全腹膜化腹腔内置补片修补术120例,腹腔镜成人免补片腹股沟疝修补术40例。结果所有手术均成功,无中转开腹。腹腔镜完全腹膜化腹腔内置补片修补术组手术时间(35.5±8.5)min,术后下床活动时间(1.3±0.4)d,疼痛持续时间(12±3.2)h,住院时间(4.0±1.6)d,住院总费用(7 642.8±684.3)元,术后并发症发生率2.5%,随访6～75个月,无复发。腹腔镜成人免补片腹股沟疝修补术组手术时间(20.4±3.5)min,术后下床活动时间(1.0±0.3)d,疼痛持续时间(10±2.5)h,住院时间(3.5±1.5)d,住院总费用(4 530.2±100.5)元。术后随访6～60个月,无复发。结论腹腔镜下应用脐襞修补成人腹股沟疝安全、有效,创伤小,恢复快,复发率低,值得临床推广。[ Objective ] To study the feasibility and superiority of the application of navel crenulation （median umbilical fold or medial umbilical fold） in laparoseopic treatment for adult inguinal hernia. [Methods] Between January 2003 and June 2008, total peritoneum intraperitoneal onlay mesh （TPIPOM） was performed in 120 adult patients with inguinal hernia, 40 adult patients were free from patch in laparoscopic herniorrhaphy. [ Results ] All the cases were performed successfully with no conversion occurred. The mean operative time was （35.5±8.5） min, the postoperative activity out of bed days was （1.3±0.4） d, the painful duration was （12±3.2） h, the length of hospital stay was （4.0±1.6） d and the total hospitalization expenditures were （7 642.8±684.3） RMB in TPIPOM group. The rate of postoperative complications was 2.86%, the follow-up period ranged from 6 to 75 months, no patients had recurrence. The mean operative time was （20.4±3.5） min, the postoperative activity out of bed days was （1.0±0.3） d, the painful duration was （10±2.5） h, the length of hospital stay was （3.5±1.5） days and the total hospitalization expenditures were （4530.2±100.5） RMB in the group free from patch in laparoscopic herniorrhaphy. The follow-up period ranged from 6 to 60 months, no patients had recurrence. [ Conclusions ] Laparoscopic herniorrhaphy with navel crenulation is safe and effective for adult patients with inguinal hernia with advantages of less injury, faster recovery and lower recurrent rate, deserves the clinical expansion.

关 键 词：脐襞 腹腔镜 腹股沟疝 疝修补术 成人 

分 类 号：R656.2[医药卫生—外科学]