腹腔镜胆囊切除联合经腹腔腹膜前腹腔镜疝修补术的研究

A study of treatment effects of laparoscopic cholecystectomy and simultaneous laparoscopic transabdominal preperitoneal(TAPP) hernioplasty

目的研究腹腔镜胆囊切除(LC)联合经腹腔腹膜前腹腔镜疝修补术(TAPP)的临床疗效。方法回顾性分析2003至2007年我们采用腹腔镜胆囊切除联合经腹腔腹膜前腹腔镜修补腹股沟疝11例临床资料,其中LC联合腹股沟单侧斜疝TAPP修补5例,LC联合腹股沟双侧斜疝TAPP修补2例,LC联合腹股沟单侧斜疝、同侧隐性直疝TAPP修补2例,LC联合腹腔镜左侧腹股沟斜疝TAPP修补、腹腔镜阑尾切除2例,观察联合手术临床疗效。结果LC联合TAPP平均手术时间为(85±35)min,术后出现尿潴留3例、无疼痛、皮下血肿、阴囊积血,术后住院平均时间2.5(2～3)d,随访2～32个月无1例复发。结论LC联合TAPP术技术新颖、损伤小、手术时间短、痛苦小、恢复快、临床可行。

Objective The aim of this study was to assess treatment effects of laparoseopic choleeystectomy and simultaneous laparoscopie transabdominal preperitoneal （TAPP） hernioplasty. Methods A retrospective analysis of clinical data of 11 patients treated in the People＇ s Hospital of Guizhou Province from July 2003 to April 2007 was performed. Of the five patients with symptomatic chronic calculous eholecystitis and unilateral primary indirect inguinal hernia were undergone laparoscopie transabdominal preperitoneal mesh hernia repair （TAPP） and LC, 2 patients with symptomatic chronic calculous eholecystitis and synchronous bilateral primary indirect inguinal hernia were received TAPP and LC, 2 patients with symptomatie chronic calculous eholecystitis and unilateral primary indirect inguinal hernia and synehronous unilateral primary inguinal direct hernia were managed by TAPP and LC, 2 patients with symptomatic chronic ealeulous choleeystitis and unilateral primary indirect inguinal hernia and chronic appendicitis were operated by laparoseopie appendectomy, TAPP and LC. A follow-up examination of each patient was performed after a median of 16 months （ range 2-32）. Results The mean operating time of laparoseopie cholecysteetomy and simultaneous laparoseopie transabdominal preperitoneal hernioplasty were （ 85 ± 35 ） minutes. Postoperative urinary retention was found in 3 patients. There were no postoperative severe pain, eechymoma, and hematoseheocele. The mean postoperative hospital stay time were （2.5 ±0.5） days. Until now, during the follow-up, none recurrent inguinal hernia has been found. Conclusions Laparoscopie eholeeysteetomy and simultaneous laparoscopie transabdominal preperitoneal hemioplasty is novelty, minor injury, shorter operating time, comfortable for patients, faster recover, and feasible for clinical.