腹膜主动切开技术在腔镜全腹膜外疝修补术中保留子宫圆韧带的应用

Application of active peritoneal incision in the maintenance of round ligament of uterus in laparoscopic total extraperitoneal hernia repair

目的探讨腹腔镜全腹膜外疝修补术(TEP)中,腹膜主动切开技术在保留子宫圆韧带中的应用价值。方法回顾性分析2014年1月年至2019年10月,中山市博爱医院普外科施行女性TEP术41例患者临床及手术资料,将其中应用腹膜主动切开技术保留子宫圆韧带及切断子宫圆韧带患者进行比较,对比手术时间、手术出血量,以及术后并发症的发生率。结果腹膜主动切开技术保留子宫圆韧带21例,切断子宫圆韧带20例,各组手术时间、手术出血量、住院天数及住院费用差异无统计学意义;两组术后疼痛、血清肿形成、腹股沟区异物感无统计学意义(P>0.05)。结论腹膜主动切开技术保留子宫圆韧带在TEP术中应用安全、可靠,不增加腹股沟疝复发及术中、术后并发症,并可保护子宫圆韧带原有解剖关系及功能。

ObjectiveTo explore the application value of active peritoneal incision in the preservation of round ligament of uterus in laparoscopic total extraperitoneal hernia repair(TEP).Methods From January 2014 to October 2019,41 cases of TEP in general surgery department of Zhongshan Boai hospital were analyzed retrospectively,and the clinical and surgical data of them were compared.The time of operation,the amount of bleeding and the incidence of postoperative complications were compared.ResultsThere were no significant differences in operation time,bleeding volume,hospitalization days and hospitalization expenses among the groups.The postoperative pain,seroma formation,and foreign body sensation in the groin area were not statistically significant in the two groups(P<0.05).There was no intraoperative side injury in each group.The incidence of postoperative complications was 0.Conclusion The technique of active peritoneal incision is safe and reliable in the application of TEP,which can not increase the recurrence of inguinal hernia and complications during and after operation,and can protect the original anatomical relationship and function of the ligament.