腹腔镜探查+疝修补术在腹股沟嵌顿疝中的应用  

Application analysis of laparoscopic exploration and herniorrhaphy in the treatment of incarcerated inguinal hernia

作　　者：孙弟[1] 顾天春[1] 陈建亮 Sun Di;Gu Tianchun;Chen Jianliang(Department of General Surgery,People's Hospital of Jingjiang,Jingjiang 214500,Taizhou,Jiangsu Province,China)

机构地区：[1]靖江市人民医院普外科胃肠病区,江苏214500

出　　处：《中华疝和腹壁外科杂志（电子版）》2021年第6期645-647,共3页Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition)

摘　　要：目的探讨腹腔镜探查+疝修补术在腹股沟嵌顿疝手术中的技巧和应用价值。方法选取2016年3月至2020年9月,靖江市人民医院收治的腹股沟嵌顿疝患者40例作为研究对象,其中有3例行腹腔镜下疝囊高位结扎+小肠破裂修补术,37例行腹腔镜探查联合TAPP术。对其临床治疗效果及并发症进行回顾性分析。结果 40例患者中,10例全身麻醉后疝自行还纳,30例在腹腔镜下直视还纳。疝内容物小肠25例,大网膜10例,乙状结肠3例,盲肠及阑尾2例。全部患者手术均成功完成,3例经回纳小肠后发现肠壁破裂,在腹腔镜下行肠壁缝合修补术,并行疝囊高位结扎,余37例患者行TAPP手术,平均手术时间(65.3±5.9)min,平均住院时间(4.4±1.8)d,术后发生阴囊血清肿2例,无补片感染患者。结论熟练掌握腹腔镜疝修补术技巧,严格掌握手术适应证,腹腔镜探查+疝修补术在急诊腹股沟嵌顿疝的治疗中安全有效,值得临床推广。Objective To explore the technique and application value of laparoscopic exploration and hernia repair in inguinal incarcerated hernia surgery.Methods 40 patients with incarcerated inguinal hernia admitted to the People's Hospital of Jingjiang between March 2016 and September 2020 were selected.3 patients underwent laparoscopic high ligation of the hernia sac and repair of small intestinal rupture,and 37 patients underwent laparoscopic exploration and TAPP.The clinical treatment and complications were retrospectively studied.Results Among the 40 patients,10 cases of hernia were restored spontaneously after general anesthesia and 30 cases of hernia were treated by laparoscopic direct vision.Hernia contents were included small intestine(25 cases),greater omentum(10 cases),sigmoid colon(3 cases),cecum and appendix(2 cases).All the operations in this group were successful.Rupture of the intestinal wall was found in 3 cases after the small intestine was restored.High ligation of hernia sac and repair of small intestinal rupture were performed under laparoscope.The remaining 37 cases were treated with TAPP and Herme hernia mesh was implanted.The mean operation time was about(65.3±5.9)minutes,and the mean hospitalization time was(4.4±1.8)days.Two patients developed scrotal seroma after surgery,and one patient was followed up,and one patient was cured after a hematoma puncture.There were no patients with a hernia mesh infection in this group.Conclusion Master the skills of laparoscopic hernia repair and strictly grasp the surgical indications,then laparoscopic exploration and hernia repair in the emergency treatment of inguinal incarcerated hernia will be safe and effective,and worthy of clinical promotion.

关 键 词：腹腔镜 疝修补术 腹股沟嵌顿疝 

分 类 号：R656.21[医药卫生—外科学]