复发性腹股沟疝的腹腔镜手术策略及疗效观察

Laparoscopic surgery strategy for recurrent inguinal hernia and the observation of therapeutic effects

目的探索分析复发性腹股沟疝患者的再次手术方法,总结临床治疗经验及腹腔镜手术的要点。方法回顾分析2019—2021年西安交通大学第一附属医院收治的52例复发性腹股沟疝患者的临床资料,依据初次手术方式的不同分为:开放疝修补术后复发、腹腔镜疝修补术后复发及其他治疗后复发。结果根据患者初次手术方式的不同,对52例复发疝患者实施个体化复发疝手术策略,其中42例行腹腔镜疝修补术,10例行开放疝修补术,手术时间为(65.1±19.8)min,住院时间为(5.9±1.9)d。其中行开放疝修补术1例患者于术后1年内复发,2例术后出现症状性血清肿。结论腹腔镜可以更好地探查复发疝情况,其治疗安全有效,对于绝大多数复发腹股沟疝患者在有经验的疝中心行腔镜手术是安全有效的手术方法。

Objective To explore and analyze the reoperation methods for patients with recurrent inguinal hernia and summarize clinical treatment experience and key points of laparoscopic surgery.Methods We conducted a retrospective analysis of the clinical data of 52 patients with recurrent inguinal hernia admitted to the First Affiliated Hospital of Xi'an Jiaotong University from 2019 to 2021.According to the different initial surgical methods,they were divided into three categories:recurrence after open hernia repair,recurrence after laparoscopic hernia repair,and recurrence after other treatments.Results According to the different initial surgical methods of the patients,a personalized strategy for recurrent hernia surgery was implemented in 52 patients,including 42 cases of laparoscopic hernia repair and 10 cases of open hernia repair.The surgical time was(65.1±19.8)minutes,and the hospital stay was(5.9±1.9)days.One patient who underwent open hernia repair experienced recurrence within one year after surgery,and two patients developed symptomatic seroma after surgery.Conclusion Laparoscopy can better explore the situation of recurrent inguinal hernia,and its treatment is safe and effective.For the vast majority of recurrent inguinal hernia patients,laparoscopic surgery at experienced hernia centers is a safe and effective surgical method.