腹腔镜完全腹膜外疝修补术治疗双侧腹股沟疝的临床研究

The clinical study of totally laparoscopic extraperitoneal herniorrhaphy on the bilateral hernia

目的探讨腹腔镜完全腹膜外双侧腹股沟疝修补术的经验。方法回顾性分析我科2002年10月至2007年5月收治的46例腹腔镜完全腹膜外双侧腹股沟疝修补术的病例资料,复习文献,总结经验。结果本组46例病人,年龄49～81岁,平均65.2岁,疝的类型包括双侧直疝15例,一侧直疝另一侧斜疝5例,双侧斜疝26例,其中9例为复发疝,43例完成腹腔镜完全腹膜外双侧腹股沟疝修补术,中转经腹腔腹膜前修补3例,完全腹膜外双侧腹股沟疝修补手术成功率93.48%。手术时间75～180min,平均96min。住院时间5～10d,平均8.5d。主要并发症为阴囊血清肿或血肿5例(10.87%),术后腹股沟区慢性疼痛1例(2.17%),膀胱损伤1例(2.17%)。无手术死亡。随访6个月～5年,术后复发1例(2.17%)。结论腹腔镜完全腹膜外双侧腹股沟疝修补术安全,效果好,复发率低,值得推广应用。

Objective To study on the clinical experience of Totally Laparoscopic Extraperitoneal Herniorrhaphy on 46 eases with bilateral inguinal hernia. Methods A retrospective study was carried out on 46 patients with bilateral inguinal hernia who were performed Totally Laparoscopic Extraperitoneal Herniorrhaphy during October 2002 to May 2007. The clinical data of these patients was analyzed. Results 46 patients who were 49 -81 ages （mean ages was 65.2） ,including 15 were bilateral direct hernia and 26 bilateral indirect hernia,5 of one side direct ＆ another side indirect hernia and 9 recurrent hernia. The rate of successful operation was 93.48%, the operation lasted 75-180 min. The mean operating duration was 96min. The patients stayed in hospital for 5-10d. The mean inpatient hospital stay was 8.5d. The mostly complications were scrotum hematomas or seromas, which appeared in 5 cases （ 10.87% ）, and the chronic inguinal pain after operation appeared in 1 cases （2.17%） ,one case had bladder injury（2.17）. There was only 1 case of recurrence（2.17% ） ,and no operative death. All the patients were followed up for 6 - 60 months. Conclusion Totally Laparoscopic Extraperitoneal Herniorrhaphy on the bilateral hernia is safe ,good effect and low recurrence rate. It is worth excellent promotion.