摘要
目的探讨腹腔镜腹腔内补片置入术(IPOM)在高龄腹股沟复发疝中的应用价值。方法应用腹腔镜腹腔内补片置入术(IPOM)治疗55例高龄腹股沟复发疝;55例复发疝患者中,年龄70～85岁,平均(76±5)岁;既往手术方式:传统疝修补术25例(45.5%),其中Bassini术15例、McWay术7例和Shouldice术3例;无张力疝修补术30例(54.5%)。第1次手术后疝复发时间6个月至15年,平均(50±12)个月。结果55例均在腹腔镜下完成手术,单侧复发疝手术时间20～45min,平均30min,双侧复发疝手术时间35～60min,平均45min。术中出血量少,术后无腹腔感染、阴囊血肿和肠粘连、肠梗阻,平均住院5～7d,55例随访6～48月,无复发。结论应用腹腔镜腹腔内补片置入术(IPOM)治疗高龄腹股沟复发疝安全可行,创伤小,操作时间短,恢复快,住院时间短,不易复发。
Objective To explore the effect and value of the application of laparoscopic intraperitoneal onlay mesh （IPOM） in recurrent inguinal hernia of elderly patients. Methods From January 2000 to June 2006, 55 elderly patients with recurrent inguinal hernia were treated with laparoscopic IPOM. The traditional herniorrhaphy without prothesis was performed in 25 cases, including 15 cases of Bassini ,7 cases of McWay and 3 cases of shouldice. Tension-free procedure was performed in 30 cases （54.5%）. The average interval from the initial surgery to recurrent was （50 ± 12） months, ranged from 6 months to 15 years. Results The operation was successfully performed under laparoscope in all cases. The operative time was 20-45 min （mean 30 rain） for unilateral recurrent hernia and 35-60 rain （mean 45 min） for bilateral recurrent hernia. The intraoperative blood loss was less, and the duration of hospital stay was 5-7 days. No infection , intestional adhesion and hematoma of the scrotum occurred after operation. The follow-up in the 55 cases ranged from 6 months to 48 months and no recurrence was found. Conclusion Laparoscopic IPOM in recurrent inguinal hernia is safe and effective for elderly oatients, with advantaees of mini-invasion, easv-ooeration, raoid recovery and low recurrent rate.
出处
《微创医学》
2007年第2期93-94,共2页
Journal of Minimally Invasive Medicine
