单侧复发性腹股沟疝腔镜下修补的临床分析  

Laparoscopic unilateral recurrent inguinal hernia repair:A clinical analysis of 123 cases

作　　者：刘国忠[1] 翁山耕[1] 胡育海[1] 陈易平 张建斌 林春忠[1] Liu Guozhong;Weng Shangeng;Hu Yuhai;Chen Yiping;Zhang Jianbin;Lin Chunzhong(Department of Hepatobiliary and Pancreatic Surgery and Hernia Surgery, Trauma medical center of Fujian Province, The First AffiliatedHospital of Fujian Medical University, Fuzhou 350005, China)

机构地区：[1]福建医科大学附属第一医院肝胆胰外科、疝外科,福建省创伤医学中心

出　　处：《中华疝和腹壁外科杂志（电子版）》2019年第5期404-407,共4页Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition)

基　　金：国家临床重点专科建设项目(2013-GJLCZD);福建省中青年教师教育科研项目(JAT160191)

摘　　要：目的探讨单侧复发性腹股沟疝腔镜下修补术的临床体会。方法回顾性分析2009年1月至2019年1月,福建医科大学附属第一医院收治的123例腔镜下修补单侧复发性腹股沟疝患者的临床资料。通过手术时间、有无中转手术、发生副损伤、术后第1天疼痛评分、术后住院时间、术后并发症发生情况,分析腔镜修补单侧复发性腹股沟疝的临床效果。结果123例单侧复发性腹股沟疝患者,采用腹腔镜完全腹膜外疝修补术(TEP)患者54例,采用腹腔镜经腹腹膜前疝修补术(TAPP)患者59例,采用腹腔内修补术(IPOM)患者10例。平均手术时间(50.68±9.46)min,术后第1天视觉模拟疼痛评分(2.19±1.76)分,术后住院时间(2.25±1.40)d。术后累计并发症患者12例(9.76%),均治愈出院,随访时间内无复发。结论腔镜修补手术(TEP、TAPP及IPOM)是治疗复发性腹股沟疝安全有效的方法,可以在有条件的单位开展。Objective To analyze and discuss the clinical experience of 123 cases of laparoscopic unilateral recurrent inguinal hernia repair. Methods Clinical and follow-up data of 123 patients with unilateral recurrent inguinal hernia undergoing laparoscopic operation in First affiliated Hospital of Fujian Medical University from January 2009 to January 2019 were analyzed retrospectively. There were 107 male and 16 female patients, and their average age were 63 years old. The clinical outcome of laparoscopic recurrent inguinal hernia repair was evaluated by operative time, converting to open operation, injury during operation, pain score on the first day after operation, postoperative hospital stay, and postoperative complication. Results There were 123 cases of unilateral recurrent inguinal repair, including 54 cases of laparoscopic totally extra-peritoneal (TEP), 59 cases of laparoscopic trans-abdominal preperitoneal hernia repair (TAPP), and 10 cases of intraperitoneal onlay mesh (IPOM). Among the 123 patients, the average operative time was (50.68±9.46)minutes, the visual analogue pain score on postoperative day1 was (2.19±1.76)scores, and the postoperative hospital stay was (2.25±1.40)days. There were 12 cases (9.76%) of postoperative complications, all discharged eventually by treatment. All patients had no recurrence in the follow-up time. Conclusion Both three laparoscopic operation (TEP, TAPP and IPOM) are safe and effective to treat unilateral recurrent inguinal hernia, can be carried out in suitable medical centers.

关 键 词：疝 腹股沟 疝修补术 腹腔镜 复发 单侧 术后并发症 

分 类 号：R656.21[医药卫生—外科学]