腹腔镜下完全腹膜外疝修补术75例  

Totally Extraperitoneal Laparoscopic Repair of Hernia: Report of 75 Cases

作　　者：刘颜良[1] 曹钧[1] 张杨[1] 袁野[1] 吴丽媛[1] 蔡逊[1] 

机构地区：[1]广州军区武汉总医院普通外科,武汉430070

出　　处：《中国微创外科杂志》2016年第11期1002-1005,共4页Chinese Journal of Minimally Invasive Surgery

摘　　要：目的探讨腹腔镜下免钉合完全腹膜外疝修补术（totally extraperitoneal,TEP）的安全性和临床疗效。方法2012年1月-2013年12月我科行腹腔镜下TEP 75例,术中充分游离腹膜前间隙,精索或子宫圆韧带骨骼化,平铺补片免钉合。结果均成功施行TEP,手术时间（62.9±16.8）min,术中出血量（18.1±5.2）ml,术后住院时间（2.8±0.7）d。术后阴囊血清肿3例,经1周理疗后阴囊血清肿逐渐吸收;手术部位腹股沟区疼痛1例,1周后自行缓解。75例随访6-32个月,平均12.6月,其中随访〉1年53例,未见复发,无腹股沟区慢性疼痛等并发症。结论免钉合TEP是一种安全可靠、复发率低的无张力疝修补术。Objective To investigate the clinical safety and curative effect of totally extraperitoneal laparoscopic repair of hernia without mesh stapling. Methods From January 2012 to December 2013,75 patients underwent totally extraperitoneal laparoscopic repair of hernia without mesh stapling. During the operation,the preperitoneal space was completely separated,and the spermatic cord or the round ligament was skeletonized,so that to place a patch without stapling. Results The surgery was successfully performed in all the patients. The operation time was（ 62. 9 ± 16. 8） min,the intraoperative blood loss was（ 18. 1 ± 5. 2）ml,and the postoperative hospital stay was（ 2. 8 ± 0. 7） days. Postoperative scrotum seroma happened in 3 patients,and was absorbed gradually after 1 week of physical treatment. Postoperative inguinal pain was found in 1 patient and was alleviated spontaneously after 1week. Follow-up for 6- 32 months（ mean,12. 6 months） in the 75 cases found no recurrence or complications. Among them,53 cases had a follow-up period for more than 1 year. Conclusion Totally extraperitoneal laparoscopic repair of hernia without mesh stapling is a safe and feasible tension-free technique for inguinal hernia,with lower recurrence rate.

关 键 词：腹腔镜 腹股沟疝 完全腹膜外疝修补术 

分 类 号：R656.2[医药卫生—外科学]