前入路腹膜前间隙无张力疝修补术157例  

Anterior preperitoneal tension-free hernia repair in 157 cases

作　　者：马富平 王志[2] 晁延军 张成[2] 克力木·阿布都热依木[2] 李英 

机构地区：[1]咸阳市中心医院肝胆科二病区,陕西省712000 [2]新疆维吾尔自治区人民医院微创,疝与腹壁外科,乌鲁木齐830001

出　　处：《中华疝和腹壁外科杂志（电子版）》2015年第1期46-48,共3页Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition)

摘　　要：目的探讨经前入路腹膜前间隙无张力疝修补术的技术要点及临床疗效。方法回顾性分析2010年3月至2014年5月,咸阳市中心医院治疗腹股沟疝157例,总结手术时间及术后并发症。结果本组157例患者手术时间25-70 min,平均（35±12）min。132例患者得到了随访。术后切口疼痛轻微26例,阴囊水肿18例,对症处理3周后均消肿;切口感染4例;补片感染2例;32例腹股沟区异物不适感多为应用加强平片所致;3例复发患者使用补片修补后治愈。结论前入路腹膜前间隙无张力疝修补是一种安全、疗效好,并发症较少的手术方式。熟悉腹横筋膜的解剖结构,准确进入腹膜前间隙,正确地选择和放置补片,酌情使用上层加强平片,是保证手术成功的关键技术要点。Objective To explore the technical skills and clinical efficacy of the anterior preperitoneal tension-free hernia repair. Methods A retrospective study was conducted in total 157 cases of inguinal hernia who were admitted to Xianyang Center Hospital from March 2010 to May 2014. The operating time and postoperative complications were summarized. Results The mean operating time in this series of157 patients was（ 35 ± 12） minutes,in the range of 25 to 70 minutes. 132 patients were successfully followed up,found with postoperative mild wound pain in 26 cases,scrotal edema in 18 cases（ relieved at3 weeks after symptomatic treatment）,wound infection in 4 cases（ 2 mesh infection）,foreign body discomfort in 32 cases（ mostly using a flat mesh to reinforce）,and 3 recurrent patients cured by mesh repair. Conclusions Anterior preperitoneal tension-free hernia repair is a safe and effective procedure with few complications. The familiarity with transversalis fascia,the accuracy of division into preperitoneal space,and the correct mesh selection and placement（ with properly using of upper flat mesh） are the key to successful operation.

关 键 词：疝 腹股沟 疝修补术 无张力 

分 类 号：R656.2[医药卫生—外科学]