腹股沟疝手术中“精索免游离”理念及其技术应用合理性的探讨  

Application of “Undissociated Spermatic Cord”Theory in Inguinal Hernia Repair

作　　者：许军[1] 李正天[1] 赵磊[1] 孔祥可 Xu Jun;Li Zhengtian;Zhao Lei(General Surgery Department,First Hospital of Harbin Medical University,Harbin 150001,China)

机构地区：[1]哈尔滨医科大学附属第一医院普外科

出　　处：《中国微创外科杂志》2019年第11期1024-1026,共3页Chinese Journal of Minimally Invasive Surgery

摘　　要：目的提出“精索免游离”理念并探讨其在腹股沟疝修补中的可行性。方法回顾性分析我院2014年3月~2018年10月132例按“精索免游离”理念行腹股沟疝修补术患者资料。男106例,女26例。Ⅰ型67例,Ⅱ型36例,Ⅲ型20例,Ⅳ型9例。“精索免游离”理念即不游离精索和疝囊,而将疝环和疝囊旷置。结果行开放式修补术126例,腹腔镜经腹腹膜前修补术(transabdominal preperitoneal repair,TAPP)5例,腹腔镜完全腹膜外修补术(total extraperitoneal repair,TEP)1例。均顺利完成手术。疝环大小(1.6±0.6)cm。其中开放式修补手术时间(29.1±3.9)min,术中出血量(3.9±1.7)ml。无出血、血清肿、补片感染等并发症。随访112例,其中1年以内13例,1~3年40例,3~5年48例,5年以上11例,均无复发,无慢性疼痛等并发症。结论遵循“精索免游离”理念可使腹股沟疝手术更加便捷,同时最大限度保留腹股沟管及精索的结构和功能,安全,可行。Objective To study on the function and significance of“undissociated spermatic cord”theory in inguinal hernia repair.Methods From March 2014 to December 2018,there were 132 patients with inguinal hernia repair undergoing“undissociated spermatic cord”theory(undissected spermatic cord and hernia sac,with hernia ring and the sac exclusion)in our hospital.The patients included 106 males and 26 females.There were 67 cases of typeⅠ,36 cases of typeⅡ,30 cases of typeⅢ,and 9 cases of typeⅣ.Results All the operations were completed smoothly,including open herniorrhaphy in 126 cases,transabdominal preperitoneal repair(TAPP)in 5 cases,and total extraperitoneal repair(TEP)in 1 case.The size of the hernia ring was(1.6±0.61)cm.For open herniorrhaphy,the mean operation time was(29.1±3.9)min and the mean blood loss was(3.9±1.7)ml.There was no bleeding,seroma,patch infection or other postoperative complications.A total of 112 patients were followed up,including 13 cases within 1 year,40 cases within 1-3 years,48 cases within 3-5 years,and 11 cases above 5 years.No recurrence or chronic pain occurred.Conclusions Following the“undissociated spermatic cord”theory,the inguinal hernia repair can be smoothly performed,with a low complication rate and recurrence rate.The function of spermatic cord can be retained.It is a safe and feasible novel idea for inguinal hernia repair.

关 键 词：精索免游离 腹股沟疝 疝结构旷置 疝囊 

分 类 号：R65[医药卫生—外科学]