超声刀在完全腹膜外疝修补术中的临床应用

Clinical application of the harmonic scalpel in totall extraperitoneal herniorrhaphy

目的:探讨超声刀在完全腹膜外(totall extraperitonea,TEP)疝修补术中的应用价值。方法:选取TEP疝修补术患者137例,对其中53例术中使用超声刀(超声刀组),与同期84例标准TEP疝修补术(对照组)进行对比分析,比较其疝类型、手术时间、术中出血量、术中并发症、是否中转其他术式、术后第1、2天引流量、术后近、远期并发症。结果:2组在性别、年龄、随访时间、疝类型、手术时间、术中并发症、术后第2天引流量及术后远期并发症方面差异均无统计学意义(P>0.05)。超声刀组术中出血量和术后第1天引流量均明显少于对照组(P<0.01);超声刀组术后阴囊血肿少于对照组(P<0.05),术中及其他术后近远期并发症方面2组差异均无统计学意义(P>0.05)。结论:超声刀在TEP疝修补术中具有一定优势,可以明显减少术中、术后出血,减少部分术中和术后近期并发症的发生。

Objective：To explore the value of a harmonic scalpel in totally extraperitoneal（TEP） inguinal hernioplasty.Methods：One hundred and thirty-seven patients who accepted TEP operation,were prospectively studied from March 2008 to August 2010 in our department：53 patients were accepted surgery with harmonic scalpel,84 patients were accepted standard surgery.The sex,age,follow-up time,type of hernia,surgery time,bleeding,intraoperative complications,transformation of other methods,postoperative drainage volume and complications were recorded.Results：There were no significant differences between harmonic scalpel group and control group at sex,age,follow-up time,type of hernia,surgery time,intraoperative complications,the second-day postoperative drainage volume and late postoperative complications（P0.05）.The bleeding,the first-day postoperative drainage volume and hematoma,in harmonic scalpel group were significantly lower than those of control group（P0.01）.Conclusions：The Harmonic Scalpel can be usd to reduce bleeding and complications.