腹腔镜经腹腹膜前疝修补术使用免钉合3D补片治疗老年腹股沟疝的体会  

Laparoscopic transabdominal preperitoneal herniorrhaphy with nonstapler 3D fixed patch in treatment of elderly inguinal hernia

作　　者：朱松[1] 侯克柱[1] 刘伟[1] 戴华佳 傅志强[1] 

机构地区：[1]上海市杨浦区市东医院,上海200438

出　　处：《腹腔镜外科杂志》2016年第2期102-104,共3页Journal of Laparoscopic Surgery

摘　　要：目的：探讨腹腔镜经腹腹膜前疝修补术（transabdominal preperitoneal,TAPP）中应用免钉合3D补片治疗老年腹股沟疝患者的效果。方法：回顾分析2011年12月至2014年6月为87例老年腹股沟疝患者应用免钉合3D补片行TAPP的临床资料。单侧腹股沟疝77例（斜疝66例,直疝8例,复发疝3例）,双侧腹股沟疝10例（斜疝8例,直疝2例）。术后随访6-26个月。结果：87例均成功施行TAPP,手术时间单侧平均（71.0±6.1）min,双侧平均（138.0±9.4）min。术后平均住院（3.2±1.1）d。术后6 h、48 h疼痛评分分别为（4.1±1.2）分与（1.9±0.6）分,术后1周恢复非限制活动率93.1%（81/87）,术后并发血清肿3例（3.4%）,术后复发1例（1.03%）。结论：使用免钉合3D补片行TAPP安全、可靠,术后疼痛轻、康复快、复发率低,是老年腹股沟疝患者理想的手术方式之一。Objective： To explore the effectiveness of laparoscopic transabdominal preperitoneal（ TAPP） herniorrhaphy with nonstapler 3D fixed patch for elderly inguinal hernia. Methods： The clinical data of 87 elderly patients with inguinal hernia who underwent laparoscopic TAPP with nonstapler 3D fixed patch from Dec. 2011 to Jun. 2014 were retrospectively analyzed. There were 77 cases of unilateral hernia,including 66 indirect inguinal hernias,8 direct inguinal hernias and 3 recurrent hernias. There were 10 cases of bilateral inguinal hernia,including 8 indirect inguinal hernias,2 direct inguinal hernias. The postoperative follow up time was 6-26 months. Results： All 87 cases underwent successful laparoscopic repair. The average operative time for unilateral hernia was（ 71. 0± 6. 1） min,and（ 138. 0 ± 9. 4） min for bilateral cases. The average postoperative hospital stay was（ 3. 2 ± 1. 1） d. The postoperative pain score was（ 4. 1 ± 1. 2） at 6 h later and（ 1. 9 ± 0. 6） at 48 h later. The percentage of resuming normal activity after 1 week was93. 1%（ 81 /87）. The most common postoperative complication was seroma（ 3. 4%,n = 3）. The recurrence rate was 1. 03%（ 1 /97）.Conclusions： TAPP technique with nonstapler 3D fixed patch is safe and reliable with little postoperative pain,fast recovery,and low rate of recurrence. It is one of the ideal operation methods for elderly inguinal hernia.

关 键 词：疝 腹股沟 疝修补术 腹腔镜检查 3D补片 老年人 

分 类 号：R656.21[医药卫生—外科学]