成年女性腹腔镜腹股沟疝修补术中保留与切断子宫圆韧带的随机对照研究  

A randomized controlled study on preservationand cutting of the uterine round ligament during laparoscopic repair of inguinal hernia in adult women

作　　者：张冬辉[1] 张剑宝[1] 庄哲宏[1] 刘业星[1] 梁智浩 张朝军[1] 

机构地区：[1]中山大学附属第八医院胃肠外科,广东省深圳市518033

出　　处：《中华疝和腹壁外科杂志（电子版）》2017年第2期115-118,共4页Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition)

摘　　要：目的探讨女性腹股沟疝腹腔镜修补术(LIHR)中保留子宫圆韧带的临床安全性。方法回顾性分析2009年11月至2016年7月,中山大学附属第八医院收治的40例(45侧)行腹腔镜女性腹股沟疝修补术患者,依术中切断子宫圆韧带与否随机分成2组进行同期对照研究,随访时间3~36个月,平均(15±3)个月。结果 2组手术时间分别为(52±15)min和(31±6)min,差异有统计学意义(P<0.05);2组均无复发及补片感染病例,引流量分别为(35±8)ml和(53±11)ml。血肿、浆液肿发生率分别为10.5%和22.2%,腹股沟神经感觉异常或慢性疼痛发生率分别为5.3%和5.6%,差异无统计学意义(P>0.05)。大阴唇水肿的发生率分别是0和27.8%,差异有统计学意义(P<0.05)。结论 LIHR术中保留子宫圆韧带在技术上是可行的,仅延长手术时间,有利于降低大阴唇水肿,对降低子宫内膜异位症、慢性盆腔炎和不孕等长期远期并发症也可能起到一定作用,因此该术式值得推广。Objective To explore the clinical safety of preservation the round ligament of the uterus in the laparoscopic repair of inguinal hernia（ LIHR） in the females. Methods From November 2009 to July2016,37 cases of laparoscopic inguinal hernia repair in females were divided into two groups in accordance with the operation of the uterine round ligament cut off or not. The follow-up period were 3 to 36 months[mean of（ 15 ± 3） months]. Results The operation time of the two groups were（ 52 ± 15） minutes and（ 31 ± 6） minutes,respectively. The difference was statistically significant（ P 〈 0. 05）. There were no recurrences and patch infections in the two groups. The drainage volume were（ 35 ± 8） ml and（ 53 ±11） ml; the incidence of hematoma/seroma were 10. 5% and 22. 2%; the incidence of inguinal nerve sensory abnormalities or pain were 5. 3% and 5. 6%,respectively. These differences were not statistically significant（ P 〉 0. 05）. The incidence of edema of the labia majora was 0 and 27. 8%,respectively,and the difference was statistically significant（ P 〈 0. 05）. Conclusion Thepreservation of the uterine ligament in LIHR is technically feasible,merelyprolongs the operation time,but it reduces the edema of the labia majora,and may help to reduce the endometriosis,chronic pelvic inflammatory disease and infertility.

关 键 词：疝 腹股沟 疝修补术 腹腔镜 圆韧带 子宫 

分 类 号：R656.21[医药卫生—外科学]