腹腔镜腹股沟疝修补术后并发症分析  

Analysis of the postoperative complication of laparoscopic inguinal hernia repair

作　　者：杨硕[1] 王明刚[1] 朱熠林[1] 曹金鑫[1] 申英末[1] 

机构地区：[1]首都医科大学附属北京朝阳医院京西院区疝和腹壁外科,北京100043

出　　处：《腹部外科》2014年第3期162-165,共4页Journal of Abdominal Surgery

摘　　要：目的 评估腹腔镜腹股沟疝修补术的疗效,分析其术后并发症的原因.方法 对2013年1～12月期间收治的581例（712例次）腹腔镜腹股沟疝修补术病例进行回顾性分析,其中经腹腹膜前补片植入术（transabdominal preperitoneal,TAPP）483例（577例次）,全腹膜外补片植入术（totalextraperitoneal,TEP） 98例（135例次）,随访时间1～14个月（平均7个月）.结果 手术无中转,术后复发率为0.3％（2/712）.术后主要并发症发生率：血肿和浆液性肿为7.4％（43/581）,尿潴留为3.6％（21/581）,术后疼痛为2.8％（16/581）.平均手术时间为（44.76±5.72） min,术后复工时间为（9.17±1.44）d.TAPP和TEP在手术时间、复发率、术后并发症发生率上差异均无统计学意义（P＞0.05）;Ⅲ型腹股沟疝的血肿和浆液性肿发生率高于其他各型腹股沟疝（P＜0.05）.结论 腹腔镜腹股沟疝修补术是安全有效的手术方式,手术方式选择需根据术者临床经验和患者具体病情决定,并发症的防治仍是临床需要进一步研究的问题.Objective By the retrospective analysis,evaluate the safety and effectiveness of the laparoscopic hernioraphy for the inguinal hernia,analyze the postoperative complication of the tech nique.Methods The data including 712 operations in 581 patients in our department undergoing the laparoscopic hernioraphy between Jan.2013 and Dec.2013 were retrospective analyzed,there were 577 operations of TAPP performed in 483 patients and 135 operations of TEP performed in 98 pa tients,all the cases were follow up 1 14 months with a median of 7 months.Results There was no conversion to open surgery occurred.The postoperative recurrence rate was 0.3 ％ （21/581）,the main complication were hematoma/seroma 7.4％ （43/581）,urinary retension 3.6％ （21/581）and postopera tive pain 2.8％ （16/581）,the operative time was （44.76 ± 5.72）min,the time for resuming work was （9.17 ± 1.44）d.There was no significant difference between TAPP and TEP in the operative time,re currence and the rate of the complications.The incidence of hematoma％seroma in the type Gilbert Ⅲ was significantly higher than other type（P＜0.05）.Conclusions laparoscopic inguinal hernia repair is safe and effective technique,the choice of the approach depends both on the surgeons＇ experience and the patient＇s condition,the prevention of complication is clinical questions that need further research.

关 键 词：腹腔镜 疝 腹股沟 手术后并发症 

分 类 号：R656.21[医药卫生—外科学]