经腹腹膜前疝修补术在腹股沟复发疝中的临床应用  

Clinical application of laparoscopic transabdominal preperitoneal hernia repair for recurrent inguinal hernia

作　　者：胡邓迪[1] 蒋能孟[1] 汪熊铁[1] 

机构地区：[1]慈溪市人民医院,浙江慈溪315300

出　　处：《腹腔镜外科杂志》2015年第2期85-87,共3页Journal of Laparoscopic Surgery

摘　　要：目的：探讨腹股沟复发疝行腹腔镜经腹腹膜前疝修补术（transabdominal preperitoneal,TAPP）的手术技巧及临床效果。方法：回顾分析2010年3月至2014年3月为37例腹股沟复发疝患者行TAPP的临床资料。其中斜疝21例,直疝16例;单侧疝31例,双侧6例（术中发现对侧隐匿疝3例）。结果：37例手术均获成功,无一例中转开放手术。手术时间38~75 min,平均（55±13）min;术中出血量15~50 ml,平均（25±10）ml;术后住院2~5 d,平均（3±1）d。术后排尿困难3例,经留置导尿3~5 d后好转。阴囊血清肿5例,4例自行吸收,1例经数次穿刺抽液好转,阴囊气肿7例,均于24 h内自行吸收;腹股沟区疼痛感2例,经口服解热镇痛药物后好转。术后随访24~36个月,平均（30±5）个月,未发现复发。结论：TAPP治疗腹股沟复发疝具有患者创伤小、康复快、并发症少的特点,是安全、可行的。Objective： To explore the surgical technique and clinical effect of laparoscopic transabdominal preperitoneal（TAPP） hernia repair for recurrent inguinal hernia. Methods：The clinical data of 37 patients of recurrent inguinal hernia treated by TAPP from Mar. 2010 to Mar. 2014 were retrospectively analyzed. There were 21 cases of indirect hernia and 16 cases of direct hernia,31 cases of unilateral hernia and 6 cases of bilateral hernia（ including 3 cases of contralateral occult hernia found during the surgery）.Results：All 37 cases of TAPP were completed successfully,nobody was converted to open operation. The operative time ranged from 38 to 75 min,the average time was（55 ± 13） min;the intraoperative blood loss was 15 to 50 ml,average blood loss was（25 ± 10） ml;The postoperative hospital stay was 2-5 d,with an average of（3 ± 1） d. 3 cases of postoperative dysuria improved after catheterization indwelled for 3-5 d. 5 cases of scrotal seroma occurred,4 cases were self-absorbed,1 case ameliorated after several times of puncture and drainage. 7 cases of scrotal emphysema were self-absorbed within 24 h. 2 cases of groin pain improved after oral antipyretic analgesics.All patients were followed up for（30 ± 5） months（ range,24-36 months）,no recurrence was found. Conclusions：TAPP is safe,feasible and mini-invasive in the treatment of recurrent inguinal hernia,and has advantages of quick recovery and few complications.

关 键 词：疝 腹股沟 复发 经腹腹膜前 疝修补术 腹腔镜检查 

分 类 号：R656.21[医药卫生—外科学]