腹腔镜下腔隙韧带切开术治疗嵌顿股疝的临床观察  

The clinical observation on the treatment of incarcerated femoral hernia by laparoscopic incisional lacunare ligamentum procedure

作　　者：范国勇[1] 甄作均[1] 姚干[1] 张庆峰[1] FAN Guoyong;ZHEN Zuojun;YAO Gan;ZHANG Qingfeng(Hernia and Abdominal Surgery,The First People＇s Hospital of Foshan,528030,China)

机构地区：[1]佛山市第一人民医院疝和腹壁外科,广东佛山528030

出　　处：《岭南现代临床外科》2018年第3期273-276,共4页Lingnan Modern Clinics in Surgery

摘　　要：目的探讨腹腔镜下腔隙韧带切开术治疗嵌顿股疝的临床疗效。方法回顾性分析我院2010年3月~2018年3月腹腔镜下腔隙韧带切开术治疗嵌顿性股疝患者的临床资料。结果 23例嵌顿股疝患者行腹腔镜下腔隙韧带切开术治疗(TAPP术式),其中男5例,女18例。术中无肠管副损伤,无因复位不了嵌顿内容物而中转开腹,但有4例患者肠坏死中转开腹行肠切除术。1例患者因术中损伤膀胱于腔镜下修补。手术时间50~180 min(平均103.36±52.87 min),出血量2~50 mL(平均13.7±10.2 mL),住院时间3~15 d(平均5.80±3.25 d)。术后15例皮下气肿,7例血清肿,1例患者伤口感染经换药治愈,1例患者术后粘连性肠梗阻保守治疗好转。随访1个月至48个月,无复发,无补片感染。结论腹腔镜下腔隙韧带切开术治疗嵌顿性股疝可以有效避免肠管副损伤,降低开腹中转率。Objective To investigate the clinical effect of laparoscopic incising lacunare ligament inthe treatment of incarcerated femoral hernia. Methods The clinical data of patients with incarceratedfemoral hernia were retrospectively analyzed in our hospital from March 2010 to March 2018. Results Twenty-three patients（5 males,18 females）with incarcerated femoral hernia underwent laparoscopiclacunare ligament dissection treatment（TAPP operation）. There was no transfer to laparotomy becausethe incarcerated contents could not be reset. Four cases of patients with intestinal necrosis were subjectedto bowel resection,and one case with bladder injury underwent laparoscopic suture. The operation timeranged from 50 to 180 min（103.36±52.87）,the bleeding was 2-50 ml（13.7±10.2）,and the length ofhospital stay was 3 to 15 days（mean 5.80 ± 3.25）. The post-subcutaneous emphysema and seromaoccurred in 15 and 7 cases respectively were cured by conservative treatment,and one case of woundinfection was cured by dressing change. Postoperative adhesion intestinal obstruction occured in onepatient and got recovery after conservative treatment. All 23 cases were followed up for 1 to 48 months.No recurrence,patch infection were found. Conclusion The surgical procedure treated incarceratedfemoral hernia by laparoscopic incising lacunare ligament can effectively avoid the secondary injury of thebowel and reduce the rate of laparotomy.

关 键 词：腹腔镜 腔隙韧带 股疝 嵌顿 

分 类 号：R656.2[医药卫生—外科学]