腹腔镜全腹膜外疝修补术331例临床分析  

Laparoscopic totally extraperitoneal hernia repair:a clinical analysis of 331 cases

作　　者：孙中伟[1] 孟岩[1] 刘国勤[1] 沈海玉[1] 姜永胜[1] 孙少川[1] 

机构地区：[1]山东大学附属济南市中心医院,山东济南250013

出　　处：《腹腔镜外科杂志》2015年第2期88-90,共3页Journal of Laparoscopic Surgery

摘　　要：目的：探讨腹腔镜全腹膜外疝修补术（totally extraperitoneal,TEP）的手术技巧及术后并发症的防治。方法：回顾分析2012年5月至2014年6月为331例（428侧）患者行TEP的临床资料,总结手术疗效与操作技巧,以减少并发症的发生。结果：330例顺利完成TEP,1例中转为腹腔镜经腹腹膜前疝修补术。手术时间30~75 min,平均（40.3±4.6）min。术后6 h即可下床活动、进半流质饮食。术后1~3 d出院,术后平均住院（1.5±0.3）d。术中出现6例腹壁下血管损伤出血。术后随访1~24个月,无复发病例及切口感染、补片感染。术后血清肿68侧（15.9%）,其中11例经穿刺抽液治愈。腹股沟区慢性疼痛（疼痛超过1个月）5例,术后3个月内疼痛均消失。结论：腹腔镜TEP可作为无全麻禁忌初发腹股沟疝患者的优先选择术式。Objective：To evaluate the operative skill and postoperative complications of the laparoscopic totally extraperitoneal hernia repair（ TEP）. Methods：The clinical data of 331 patients（428 sides） of TEP from May 2012 to Jun. 2014 were retrospectively analyzed,the operation curative effect and the operative techniques of TEP were summarized to reduce the complications. Results：One case was converted to transabdominal preperitoneal surgery,the other operations were successful. Operation time was（40. 3 ± 4. 6） min（range,30-75 min） per side. Patients began to take the semi-liquid diet and light physical activity 6 h after operation. Average postoperative hospital stay was（1. 5 ± 0. 3） d（ range,1-3 d）. The injury of inferior epigastric blood vessel occurred in 6 cases. No relapse,incision infection or patch infection were found during the follow-up of 1-24 months. 68 sides（15. 9%） of postoperative seroma occurred,in which 11 cases were cured by puncture and drainage. 5 cases suffered from chronic pain（ 1 month） in the inguinal region and the pain disappeared within 3 months. Conclusions：Laparoscopic TEP is a prior choice for primary hernia patients who have no contraindications of general anesthesia.

关 键 词：疝 腹股沟 全腹膜外 疝修补术 腹腔镜检查 手术后并发症 

分 类 号：R656.2[医药卫生—外科学]