腹腔镜经腹腔腹膜前疝修补术治疗老年复发性腹股沟疝39例分析  

Laparoscopic transabdominal preperitoneal repair for recurrent inguinal hernia in elderly patients: A clinical analysis of 39 patients

作　　者：王曦滔 黄耿文[1] 申鼎成 林嘉晏 宁彩虹 曹昕彤 纪连栋[1] 陆晔斌[1] 魏伟[1] WANG Xi-tao, HUANG Geng-wen, SHEN Ding-cheng, et al(Department of Pancreatobiliary Surgery, Xiangya Hospital of Central South University, Changsha 410008, Chin)

机构地区：[1]中南大学湘雅医院普外胰胆外科,湖南长沙410008

出　　处：《中国实用外科杂志》2018年第8期922-924,共3页Chinese Journal of Practical Surgery

摘　　要：目的探讨老年复发性腹股沟疝的腹腔镜手术治疗效果。方法回顾性分析2010年4月至2017年4月中南大学湘雅医院普外胰胆外科收治的39例(年龄≥60岁)行腹腔镜经腹腔腹膜前疝修补术(TAPP)的复发性腹股沟疝病例及其定期随访结果。结果 39例病人顺利完成TAPP手术治疗,中位手术时间50(40~130)min。术后第1天中位疼痛评分为2(0~6)分。术后尿潴留发生率为2.6%(1/39),血清肿发生率为5.1%(2/39),术后疼痛发生率为5.1%(2/39)。术后中位住院时间为2(1~6)d。32例(82.1%)病人获得术后随访,中位随访时间为25(12~88)个月。术后1个月腹股沟区疼痛调查表(IPQ)中位评分为2(0~4)分。随访期间,无术后再复发、切口及补片感染和腹股沟区慢性疼痛病例。结论对可耐受全身麻醉、前入路手术后复发的老年腹股沟疝,TAPP治疗安全有效。对腹膜前间隙有粘连的老年复发疝病人可审慎选择TAPP治疗,粘连广泛的病人应选择开放或杂交手术治疗。Objective To investigate the clinical value of laparoscopic transabdominal partial extraperitoneal （TAPE） hernia repair for scrotal hernia in the elderly patients. Methods The clinical data of 11 elderly patients with scrotal hernia who underwent TAPE from March 2016 to December 2017 in the Department of Geriatrics, the Second Xiangya Hospital of Central South University were retrospectively analyzed, which included perioperative situations, postoperative complications and follow-up. Results The operation duration of 11 patients as 30-40 minutes. Oral feeding and postoperative activity were resumed 4-6h after surgery. Postoperative hospital stay was 2 days. Postoperative analgesic was not used and no infection, seroma and scrotal swelling was witnessed in 2 weeks. There was no recurrence, chronic pain and numbness during 4-26 months of follow-up. Conclusion TAPE is convinient and potential for the treatment of scrotal hernia in the elderly patients.

关 键 词：老年 腹股沟疝 复发 腹腔镜 

分 类 号：R6[医药卫生—外科学]