完全腹膜外疝修补术中辅助使用穿刺排气法治疗对侧隐匿疝的临床价值  

Laparoscopic totally extraperitoneal preperitoneal hernia repair assisted with puncture and degassing method ∶ a modified technique for contralateral occult hernia

作　　者：曹赣[1] 葛永祥[1] 田野[1] 刘庆宏[1] 

机构地区：[1]南通大学附属泰州市人民医院普外科,江苏泰州225300

出　　处：《中华疝和腹壁外科杂志（电子版）》2015年第1期9-10,共2页Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition)

基　　金：江苏省333人才工程研究基金资助项目

摘　　要：目的探讨在完全腹膜外疝修补术（TEP）中发现对侧隐匿疝,应用穿刺排气法行TEP治疗的临床效果。方法回顾性分析2010年2月至2013年6月,南通大学附属泰州市人民医院收治的腹股沟疝患者40例的临床资料,行TEP术,术中发现对侧隐匿疝8例,均辅助使用穿刺排气法行对侧TEP。结果 40例手术时间30-70 min,8例双侧疝TEP修补术时间50-70 min,术后2-4 d出院,随访5-12个月,无疝复发。在腹膜破损的情况下,穿刺排气法可以辅助完成TEP,不会明显延长手术时间和增加手术难度。结论 TEP术中探查发现对侧隐匿疝,可辅助使用穿刺排气法行TEP治疗,缩短手术时间,减少腹膜损伤与腹腔镜疝修补术并发症。Objective To explore the clinical effect of puncture and degassing method in laparoscopic totally extraperitoneal（ TEP） hernia repair when the contralateral occult hernia exists. Methods A total of 40 cases of inguinal hernia were treated by TEP in Taizhou People＇ s Hospital from February2010 to June 2013,and their clinical datas were retrospectively analyzed. 8 cases with contralateral occult hernia found in operation were applied with puncture and degassing method,then TEP was continued.Results The operation time was 30 to 70 minutes,Postoperative hospital stay was 2 to 4 days. During the follow-up of 5 to 12 months,there was no recurrence. In the case of peritoneal perforation,the puncture and degassing method could be used to assist TEP, without significantly prolonging the operative time or increasing the operating difficulty. Conclusion When a contralateral occult hernia exists,the method of puncture and degassing can be applied in TEP to reduce operative time,and decrease the incidence of peritoneal injury and complications.

关 键 词：疝 腹股沟 疝修补术 腹腔镜 穿刺术 

分 类 号：R656.21[医药卫生—外科学]