程序化分离建立腹膜前间隙在腹腔镜完全腹膜外疝修补术中的应用  

Application of programmed separation constructed preperitoneal space established by procedural separation to laparoscopic totally extraperitoneal hernioplasty

作　　者：黄庆录[1] 李鸿飞[1] 黄莉桔 蔡小勇[2] HUANG Qing-lu;LI Hong-fei;HUANG Li-ju;CAI Xiao-yong(Department of General Surgery,the People′s Hospital of Hechi,Hechi 547000,China;Department of General Surgery,the Second Affiliated Hospital of Guangxi Medical University,Nanning 530007,China)

机构地区：[1]河池市人民医院普通外科,广西河池市547000 [2]广西医科大学第二附属医院普通外科,南宁市530007

出　　处：《广西医学》2019年第20期2602-2605,2625,共5页Guangxi Medical Journal

摘　　要：目的探讨腹腔镜完全腹膜外疝修补术(TEP)中运用程序化分离建立腹膜前间隙的临床效果。方法将100例行腹腔镜TEP的成人腹股沟疝患者随机分为研究组、对照组,各50例。研究组采用程序化分离的方法建立腹膜前间隙,对照组采用传统的方法建立腹膜前间隙。比较两组患者围术期指标及并发症发生情况。结果两组患者均顺利完成手术,无中转开腹手术。研究组手术时间、术中出血量、术后进食时间、术后下床活动时间、术后住院时间均短于或低于对照组(均P<0.05);研究组腹壁下动脉损伤、腹膜破损、慢性疼痛、血清肿的发生率均低于对照组(均P<0.05),但两组患者切口感染发生率比较,差异无统计学意义(P>0.05)。结论采用程序化分离法创建腹膜前间隙可以提高腹腔镜TEP的手术效率和安全性,减少手术并发症。Objective To explore the clinical effect of preperitoneal space established by procedural separation on laparoscopic totally extraperitoneal hernioplasty(TEP).Methods A total of 100 adult patients with inguinal hernia undergoing laparoscopic TEP were randomly divided into study group and control group,with 50 cases in each group.The procedural separation method was employed to establish preperitoneal space in the study group,and the conventional method was performed to establish preperitoneal space in the control group.The perioperative indicators and the incidence of complications were compared between the two groups.Results The operation was successfully completed in both groups without conversion to laparotomy.The operation time,intraoperative bleeding volume,durations for postoperative feeding and ambulation,postoperative hospital stay were shorter or less in the study group than in the control group(all P<0.05).In comparison with the control group,the incidence rates of inferior epigastric artery injury,peritoneal rupture,chronic pain and seroma in the study group all decreased(all P<0.05),but there was no statistically significant difference in the incidence rate of incision infection between the two groups(P>0.05).Conclusion Employing programmed separation method to construct preperitoneal space established by procedural separation can increase operative efficiency and security of laparoscopic TEP,and reduce operative complications.

关 键 词：腹股沟疝 疝修补术 腹膜前间隙 程序化分离 腹腔镜手术 并发症 

分 类 号：R656.2[医药卫生—外科学]