正中切口行腹股沟疝腹膜外修补术102例  

Inguinal Hernia Extraperitoneal Repair Through Midline Incision:a Report of 102 Cases

作　　者：孙荣勋[1] 陈江[1] 张大伟[1] 李小燕[1] 姚君良[1] 

机构地区：[1]复旦大学附属金山医院普外科,上海201508

出　　处：《中国微创外科杂志》2016年第8期746-748,共3页Chinese Journal of Minimally Invasive Surgery

摘　　要：目的总结腹股沟疝行正中切口腹膜外修补术的解剖要点和操作体会。方法 2011年2月-2015年8月102例腹股沟疝经正中切口行完全腹膜外修补,手术步骤依次为分开腹直肌,分离腹膜外筋膜和腹横筋膜间粘连,建立腹膜外间隙,剥离疝囊,以疝环为中心将补片完全覆盖肌耻骨孔,补片与腹直肌缝合固定。结果手术时间28-55 min,平均37min。术后住院时间1-4 d,平均1.5 d。术后尿储留3例（2.9%）,皮下、阴囊血清肿和血肿3例（2.9%）,无慢性疼痛。95例随访6个月-5年,平均3年,无慢性疼痛,术后复发2例（1.9%）,均发生在术后6个月,采用网塞法行再次修补,其余患者无异常。结论经正中切口腹膜外修补术具有操作便捷、术后腹股沟区无不适感等优势。Objective To summarize anatomic landmarks and operative techniques in the extraperitoneal repair through midline incision for inguinal hernia. Methods From February 2011 to August 2015,102 patients with inguinal hernia received extraperitoneal herniorrhaphy through a midline incision. After separating the rectus abdominis muscles,the adhesion between the extroperitoneal fascia and the transvasalis fascia was dissected,and the preperitoneal space was established. Then the hernia sac was isolated. The prosthesis patch was placed on the myopectineal orifice,with the hernia ring locating at the center of the patch. Finally,the patch rim was fixed to the rectus. Results The operative time was 28- 55 min（ mean,37. 2 min）. The postoperative hospital stay was 1- 4 d（ mean,1. 5 d）. Urinary retention occurred in 3 cases（ 2. 9%）. Seroma occurred in 3 cases（ 2. 9%）. A total of 95 cases were followed up for 6 months- 5 years,with an average of 3 years. There was no patient developing chronic pain. Postoperative recurrence was noted in 2 cases（ 1. 9%）,both occurring within 6 months after operation,and were treated with reoperations with plug method. The other patients were normal. Conclusion The extraperitoneal repair through midline incision has advantages of convenient procedure and less postoperative groin discomfort.

关 键 词：腹膜外修补 腹股沟疝 正中切口 

分 类 号：R656.21[医药卫生—外科学]