手术治疗单侧腹股沟疝合并子宫圆韧带囊肿128例分析  

Analysis of surgical treatment of 128 female unilateral inguinal hernia patients with cyst of round ligament of uterus

作　　者：马秋月 刘小莉 孙蕊 杨慧琪 陈杰[1] MA Qiu-yue;LIU Xiao-li;SUN Rui(Department of Hernia and Abdominal Wall Surgery,Beijing Chaoyang Hospital,Capital Medical University,Beijing 100043,China)

机构地区：[1]首都医科大学附属北京朝阳医院疝和腹壁外科,北京100043

出　　处：《中国实用外科杂志》2023年第4期437-439,448,共4页Chinese Journal of Practical Surgery

基　　金：吴阶平医学基金会临床科研专项资助基金(No.320.6750.2021-07-1)。

摘　　要：目的探讨单侧腹股沟疝合并子宫圆韧带囊肿的临床特征及手术治疗效果。方法回顾性分析2015-01-01至2020-12-31首都医科大学附属北京朝阳医院疝和腹壁外科收治的128例女性单侧腹股沟疝合并子宫圆韧带囊肿病人的临床资料,分析其临床特点、手术方法及术后情况。结果77.3%的病人年龄<45岁;8.6%包块有压痛,26.6%平卧时包块不能完全还纳;3.9%为复发疝;73.4%为右侧腹股沟疝,以Ⅱ型(68.8%)和Ⅲ型(27.3%)为主;88.3%为单发子宫圆韧带囊肿。手术方式以Lichtenstein手术(76.6%)和腹腔镜手术(15.6%)为主。子宫圆韧带囊肿在开放手术和腹腔镜手术中均可进行处理,82.0%的病人通过手术完整切除囊肿,7.0%切除部分圆韧带及囊肿,7.0%切开囊肿引流。3例(2.3%)病人由于粘连致密或无法触及远端圆韧带囊肿,腹腔镜手术中转Lichtenstein手术;2例(1.6%)行腹腔镜手术联合开放切除囊肿。20例腹腔镜手术病人术后疼痛发生率为15.0%,108例其他手术方式病人术后疼痛发生率为16.7%。115例病人中位随访时间为29 d,共23例病人出现并发症,以局部组织肿胀疼痛为主(13例)。结论单侧腹股沟疝合并子宫圆韧带囊肿病人多数年龄<45岁,主要为Ⅱ或Ⅲ型斜疝、右侧疝、单发子宫圆韧带囊肿;开放手术和腹腔镜手术均可修补腹股沟疝同时处理子宫圆韧带囊肿,术后疼痛发生率相近,但开放手术在处理子宫圆韧带远端囊肿时具有一定优势。Objective To investigate the clinical characteristics,surgical methods and postoperative outcomes of female unilateral inguinal hernia with cyst of round ligament of uterus.Methods A retrospective cross-sectional study was conducted.Clinical data of 128 female patients with unilateral inguinal hernia and cyst of round ligament of uterus was collected,who were admitted to the Department of Hernia and Abdominal Wall Surgery,Beijing Chaoyang Hospital,Capital Medical University from January 1,2015 to December 31,2020.The clinical characteristics,surgical conditions and postoperative outcomes of the patients were described.Results 77.3%of the patients were<45 years old,8.6%had bulge tenderness,26.6%had irreducible bulge,and 3.9%had recurrent hernia.73.4%had right side hernia,mainly typeⅡ(68.8%)and typeⅢ(27.3%).88.3%had single round ligament cyst.The main surgical methods were Lichtenstein repair(76.6%)and laparoscopic repair(15.6%).Cyst of round ligaments can be managed in both open and laparoscopic repairs.Complete cyst resection was performed in 82.0%of the patients,partial round ligament and cyst resection was performed in 7.0%,and cyst drainage was performed in 7.0%.Three patients(2.3%)converted from laparoscopic repair to Lichtenstein repair due to adhesion density or unable to reach the distal round ligament cyst.Two patients(1.6%)underwent laparoscopic repair assist with open cyst resection surgery.The rate of postoperative pain was 15.0%in 20 patients who underwent laparoscopic repair,and was 16.7%in 108 patients who underwent other surgical methods.The median follow-up time was 29 days in 115 patients.23 of them had complications,mainly local tissue swelling and pain(13 cases).Conclusion Female unilateral inguinal hernia patients with round ligament cyst are mainly under 45 years old.TypeⅡandⅢ,right side hernia and single round ligament cyst are common in these patients.Both Lichtenstein repairs and laparoscopic repairs can repair inguinal hernia and manage round ligament cyst at the same time,and the

关 键 词：女性 腹股沟疝 子宫圆韧带囊肿 腹股沟疝修补术 

分 类 号：R6[医药卫生—外科学]