完全腹膜外腹腔镜腹股沟疝修补术的临床应用

Clinical application experience of total extraperitoneal prosthetic with laparoscopic herniorrhaphy

目的:总结完全腹膜外腹腔镜腹股沟疝修补术(totally extraperitoneal prosthetic,TEP)的临床应用经验。方法:回顾分析2007年4月至2008年8月我院收治的58例腹股沟疝患者行TEP手术的临床资料。其中直疝16例、斜疝42例;单侧疝46例、双侧疝12例;复发疝16例。结果:手术均获成功,无中转手术。手术时间50～140min(平均单侧90min、双侧120min)。术后无须使用镇痛剂,住院时间3～10d,平均5d。术后出现阴囊血肿4例,血清肿21例。随访1～15个月,术后无复发。结论:TEP手术安全可靠,具有并发症少,术后疼痛轻、康复快、复发率低等优点,可同时对双侧疝进行处理,无需全身麻醉,具有明显的优越性,有广泛的应用前景,是值得临床推广的微创技术。

Objective：To summarize clinical application experience of total extraperitoneal prosthetic （TEP） with laparoscopic herniorrhaphy. Methods： The clinical data of 58 cases who were performed TEP were retrospectively analyzed from Apr. 2007 to Aug. 2008,including 16 direct inguinal hernias and 42 indirect inguinal hernias. Among 58 patients ,46 patients suffered unilateral hernias and 12 patients suffered bilateral hernias,including 16 recurrent hernias. Results：All patients were performed successfully by TEP. The operative time was 50-140min（ the mean of unilateral hernia was 90min and bilateral hernia was 120min）. The patients didnt need analgesics. The hospital stay was 3-10d （mean 5d）. 4 cases occurred hematoma of scrotum and 21 cases occurred seroma. All patiences were followed up 1-15 months without recurrence. Conclusions：The procedure of TEP is safe, with faster postoperative recovery, less pain,lower recurrencerate and worth wide generalization.