腹腔镜全内脏囊分离技术在腰疝中的应用分析  

Application of laparoscopic total visceral sac separation technique for treatment of lumbar hernia

作　　者：王海波 潘春鹏 王守练[1] 倪晓春[1] 张驰豪[1] 俞继卫[1] Wang Haibo;Pan Chunpeng;Wang Shoulian;Ni Xiaochun;Zhang Chihao;Yu Jiwei(Department of General II Surgery,Shanghai Ninth People's Hospital,School of Medicine,Shanghai Jiao Tong University,Shanghai 200011,China)

机构地区：[1]上海交通大学医学院附属第九人民医院普外二科,200011

出　　处：《中华疝和腹壁外科杂志(电子版)》2025年第1期35-39,共5页Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition)

基　　金：国家自然科学基金青年项目(82200630)。

摘　　要：目的探讨腹腔镜下全内脏囊分离技术(TVS)在腰疝的应用效果。方法统计收集2020年1月至2022年12月,就诊于上海交通大学医学院附属第九人民医院普外二科的12例腰疝患者,其中11例为原发性腰疝,1例继发性腰疝(肾囊肿开窗引流术后),观察患者一般资料、手术时间、术后疼痛评分、住院时间、缺损直径、术后并发症,并随访术后复发率。结果所有患者均成功完成了腹腔镜全腹膜外修补术,手术时间为45~112 min,平均时间约79 min;术后疼痛视觉模拟评分为1~3分,平均2.3分;术后住院时间2~4 d,平均2.7 d;缺损直径1.6~3 cm,平均2.3 cm。2例患者出现血清肿,未予以特殊处理,随访3个月后自行吸收,无伤口感染、血肿、慢性疼痛发生。随访时间5~15个月,未出现疝复发。结论腹腔镜下TVS用于腰疝的治疗安全、可靠、创伤小。bjective To investigate the application of laparoscopic total visceral sac separation(TVS)in lumbar hernia.Methods A total of 12 cases of lumbar hernia were admitted to the Department of GeneralⅡSurgery,the Ninth People's Hospital of Shanghai Jiao Tong University School of Medicine from January 2020 to December 2022 were statistically collected,including 11 cases of primary lumbar hernia and 1 case of acquired lumbar hernia(after renal cyst fenestration and drainage surgery).General information,operation time,postoperative pain score,length of stay,the diameter of defect,postoperative complications,and postoperative recurrence rate were observed.Results All patients successfully underwent totally extraperitoneal(TEP)laparoscopic hernia repair.The operative time ranged from 45 to 112 minutes,with an average duration of 79 minutes.Postoperative pain,assessed using the visual analog scale(VAS),ranged from 1 to 3,with a mean score of 2.3.The postoperative hospital stay ranged from 2 to 4 days,averaging 2.7 days.The defect diameter measured 1.6 to 3 cm,with a mean of 2.3 cm.Two patients developed seromas,which were managed conservatively and resolved spontaneously within three months of follow-up.No cases of wound infection,hematoma,or chronic pain were observed.During a follow-up period of 5 to 15 months,no hernia recurrence was reported.Conclusion Laparoscopic TVS is safe,reliable and less traumatic in the treatment of lumbar hernia.

关 键 词：腰疝 全内脏囊分离技术 腹腔镜 

分 类 号：R65[医药卫生—外科学]