腹腔镜经腹腹膜前疝修补术的临床体会

Clinical experience of transabdominal preperitoneal laparoscopic inguinal hernioplasty

目的:探讨腹腔镜下经腹腹膜前修补术(TAPP)治疗腹股沟疝的有效性及优越性。方法:对2003年10月至2007年12月所施行的40例TAPP术的临床资料进行回顾性分析,包括手术时间、术后住院时间、住院费用、并发症发生率及疝复发率等。结果:40例TAPP术均成功完成,无中转开腹,平均手术时间为(49.1±10.9)min,术后留院平均为(2.9±1.0)d,住院费用平均为(7 306.6±621.0)元,随访6～48个月,无一例复发。结论:TAPP是一种安全可靠的腹股沟疝手术治疗方法,具有创伤小、疼痛轻、恢复快、操作简单、住院时间短、复发率低等优势;特别值得推广应用于复发疝、双侧疝等情况。

Objective To discuss the efficacy and advantages of transabdominal preperitoneal laparoscopic inguinal hemioplasty. Methods The clinical data from 40 patients submitted to laparoscopic inguinal hernioplasty with the transabdominal preperitoneal （TAPP） procedure from October 2003 to December 2007, were retrospectively analyzed; including the operating time, postoperative hospital stay, cost, rate of complications and recurrence rate. Results TAPP was successfully performed on all these patients, with no conversion to open surgery. The average operating time was （49.1±10.9） minutes, the average hospital stay was （2.9±1.0） days, and the total cost was （7 306.6±621.0） RMB. No recurrence was observed during the 6 to 48 months of follow-up. Conclusions TAPP is a safe and applicable procedure for inguinal hernia repair, with advantages of minimal invasion, better recovery, simple procedure, short hospital stay, and low recurrence rate. This technique is most suitable for bilateral and recurrent hernias.