摘要
目的总结成人腹股沟疝腹腔镜修补术的经验，分析常见的手术并发症和术后复发原因。方法回顾性分析2007年3月至2010年9月行腹腔镜腹股沟疝修补术512例患者的临床资料，单侧腹股沟疝437例（斜疝281例、直疝86例、股疝15例、复合疝16例，复发疝39例），双侧腹股沟疝75例（含复发疝3例），其中包括急性腹股沟嵌顿疝41例。术后平均随访时间（29±12）个月。结果512例中，507例患者成功行腹腔镜修补，完成经腹腹膜前补片植入术（transabdominal preperitoneal，TAPP）238例（292侧），完全腹膜外补片植入术（totally extraperitoneal，TEP）269例（290侧）；5例中转开放手术。平均手术时间TAPP（69±19）min、TEP（58±15）min；术后平均住院时间（5．0±1．5）d；术后2周和4周恢复非限制活动人数分别为95．7％（485／507）、99．0％（502／507）；术后并发症依次为血清肿9．7％（49／507）、暂时眭神经感觉异常4．1％（21／507）、术后慢性疼痛0．8％（4／507）。术后复发率0．6％（3／507）。结论腹腔镜腹股沟疝修补术具有创伤小，恢复快，复发率低等优点。
Objective To summarize the experiences in laparoscopic inguinal hernia repairing for adult patients. Methods Clinical data of 512 hernia cases admitted in our center from March 2007 to Sep 2010 were retrospectively analyzed. There were 437 cases of single-sided hernia, including 281 indirect inguinal hernia, 86 direct inguinal hernia, 15 femoral hernia, 16 combined inguinal hernia and 39 recurrent hernia. There were also 75 cases of double-sided inguinal hernia, including 3 recurrent hernia. There were 41 acute incarcerated hernia cases. The average postoperative follow up time was （29 ± 12） months. Results 507 cases underwent successful laparoscopic repair, and 5 cases were converted to open procedure. There were 238 TAPP and 269 TEP in laparoscopic operations. The average operative time for TAPP was （69 ± 19） rain, and （58 ± 15） min for TEP. The average length of postoperative stay was （5.0 ± 1.5） days. The percentage of resuming normal activity after 2 weeks and 4 weeks were 95.7% （485/507） and 99.0% （502/507）. The most common postoperative complications were seroma （9.7%, 49/507 ）, transient paresthesia （4. 1%, 21/507） and chronic pain （0. 8%, 4/507）. The recurrence rate was 0. 6% （3/507）. Conclusions Laparoscopic repair of inguinal hernia has the advantage of less trauma, faster recovery, and lower Tecurrence rate.
出处
《中华普通外科杂志》
CSCD
北大核心
2012年第3期200-203,共4页
Chinese Journal of General Surgery
关键词
疝
腹股沟
腹腔镜
疝修补术
Hernia,inguinal
Laparoscopes
Hernia repairing
