“T”形切开法横断疝囊在腹腔镜经腹腹膜前疝修补术治疗完全性阴囊疝中的应用体会  

Application of “T” Shaped Incision Transverse Hernia Sac in the Treatment of Complete Scrotal Hernia by Transabdominal Preperitoneal Inguinal Hernia Repair

作　　者：舒仕龙[1] 杨华[1] 张发强[1] 金心富[1] 兰柯 SHU Shilong;YANG Hua;ZHANG Faqiang(Zigong Fourth People’s Hospital,Zigong 643000,China)

机构地区：[1]自贡市第四人民医院,四川自贡643000

出　　处：《中外医学研究》2018年第35期16-18,共3页CHINESE AND FOREIGN MEDICAL RESEARCH

摘　　要：目的:介绍一种横断疝囊的新方法,探讨此种方法在完全性阴囊疝行腹腔镜经腹腹膜前疝修补术(transabdominal preperitoneal,TAPP)中的可行性。方法:回顾性分析2017年1-12月,自贡市第四人民医院普外二科30例疝内容物掉入阴囊,行TAPP术的患者的病例资料。采用"T"形切开法横断疝囊。总结其处理疝囊时间、手术时间、手术出血量、术后并发症发生率(切口感染、阴囊积液、暂时性神经感觉异常、缺血性睾丸炎等)、住院时间及术后复发率等方面。结果:全部患者均采用"T"形切开法横断疝囊完成手术;无肠管、精索、输精管损伤。处理疝囊时间为(11.0±3.0)min,手术时间为(50.0±5.0)min,出血量为(2.0±0.5)ml。均在术后第3天出院,患者术后未出现切口感染、暂时性神经感觉异常、缺血性睾丸炎;出现1例腹股沟积液和2例阴囊积液,给予热敷后均在14 d内消退。结论:"T"形切开法横断疝囊在TAPP术完全性阴囊疝的疝囊处理简单快捷,降低疝囊处理难度,缩短手术时间,降低手术并发症,值得临床推广。Objective:To introduce a new method of transection of hernia sac and explore the feasibility of the hernia sac transection in transabdominal preperitoneal for complete scrotal hernia.Method:A retrospective analysis was made from January 2017 to December 2017.30 cases of hernia content falling into the scrotum in the department of general surgery of Zigong Fourth People's Hospital were analyzed.The hernia sac was transected by the“T”shaped incision.The incidence of postoperative complications(incisional infection,scrotal effusion,transient neurosensory abnormalities,ischemic orchitis),the time of hospitalization and the postoperative recurrence rate were summarized.Result:All patients were operated by“T”shaped incision and transection of hernia sac.No intestinal canal,spermatic cord or vas deferens injury occurred.The time of treatment of hernia sac was(11.0±3.0)min,the time of operation was(50.0±5.0)min,the amount of bleeding was(2.0±0.5)ml.All the patients were discharged from hospital third days after operation.There were no infection of incision,transient neurosensory and ischemic orchitis after operation,1 case of inguinal effusion and 2 cases of scrotum effusion,which subsided in 14 day after hot compress,and no recurrence was found.Conclusion:It is simple and quick to deal with hernia sac in TAPP operation of complete scrotal hernia by“T”shape incision,and it can reduce the difficulty of treating the hernia sac,shorten the operation time and reduce the complications of the operation.It is worth popularizing in clinical practice.

关 键 词：疝 腹股沟 腹腔镜 血清肿 疝囊横断 

分 类 号：R656.21[医药卫生—外科学]