腹腔镜修补成年女性腹股沟疝的临床研究  

Clinical study of laparoscopic female inguinal hernia repair

作　　者：梁庆余[1] 谢佳明[1] 吴浩荣[1] 谷春伟[1] 危少华[1] 任杰[1] 

机构地区：[1]苏州大学附属第二医院普外科,江苏苏州215000

出　　处：《中华腔镜外科杂志（电子版）》2014年第1期35-38,共4页Chinese Journal of Laparoscopic Surgery(Electronic Edition)

摘　　要：目的探讨女性腹股沟疝的特殊性及腹腔镜下修补的临床疗效。方法回顾性分析2009年5月至2013年3月苏州大学附属第二医院普外科41例成年女性腹股沟疝腹腔镜下修补的临床资料。结果4l例（46侧）均在腹腔镜下顺利完成腹股沟疝修补术，其中完全腹膜外修补术（totallyextraperitoneal，TEP）28例（32侧），经腹腹膜前修补术（transabdominalpreperitoneal，TAPP）11例（12侧），腹腔内修补术（intraperitonealonlaymesh，IPOM）2例（2侧）。术中发现股疝误诊为腹股沟斜疝2例；3例术前诊断为单侧疝，术中发现对侧隐匿疝；2例患者术中发现合并子宫圆韧带囊肿，术后发生血清肿6例（14．6％）；修补区域异物感4例（9．8％）；术后急性疼痛5例（12．2％），4例3～6周后基本缓解，1例持续疼痛2个月以上，无腹腔脏器损伤、术后出血、感染、术后尿潴留等并发症的发生，所有患者4周内基本恢复非限制性活动，随访期间各修补方式患者均无复发。结论腹腔镜下女性腹股沟疝修补方式覆盖了整个薄弱的耻骨肌孔区域，可以有效的防止女性腹股沟区继发疝的发生，并且具有创伤小、恢复快、美观等优点，术中子宫圆韧带连续性应尽量予以保留，有利于将来女性患者的生活。Objective To discuss the particularity of the female inguinal hernia and evaluate the effect of laparoscopic inguinal hernia repair in adult females. Methods The clinical and follow-up data of 41 cases of laparoscopic inguinal hernia repair among female patients performed from May 2009 to March 2013 at the 2nd Affiliated Hospital of Soochow University were analyzed retrospectively. Results 41 female patients with inguinal hernia were treated successfully with laparoscopy repair. 28 patients were underwent TEP, llTAPP and the other 2 were underwent IPOM. 3 cases of femoral hernia were diagnosed inguinal hernia by mistake preoperatively. 3 cases of bilateral hernia were diagnosed with an unilateral hernia preoperatively. In addition, 2 cases of patients with uterine round ligament cyst intraoperatively. Seroma occurred in 6 cases; 4 cases had local foreign body sensation; abdominal wall pain oecmTed in 5 cases （12.2%）, 4 cases of them basically relief after 3 - 6 weeks and the left one patient suffered from pain for more than two months. There were no complications such as intra-abdominal organ injuries, postoperative bleeding, infection, postoperative urinary retention. All patients restored the non-restrictive activities within 4 weeks and no recurrence occurred during the follow-up time. Conclusion Laparoscopic female inguinal hernia repair covers the entire myopectineal orifice,which can effectivelyprevent secondary hernia. In addition, laparoscopic female inguinal hernia repair has the advantages of less trauma, faster recovery and better cosmetic result. We cautiously assert that preserving round ligament can be a support for the internal genitalia organs and can be an advantage in future life for female patients.

关 键 词：腹股沟疝 腹腔镜 女性 子宫圆韧带 

分 类 号：R656.21[医药卫生—外科学]