腹腔镜腹股沟疝修补术并发症的防治(附124例)

Prevention and treatment of complications for laparoscopic inguinal hernia repair.(with 124 cases)

目的探讨腹腔镜下腹股沟疝修补术手术效果与并发症防治。方法回顾性分析我院2007年10月至2010年12月接受经腹腔腹膜前疝修补术(TAPP)和完全腹膜外腹腔镜疝修补术(TEP)患者的临床资料,治疗效果和并发症发生率。结果本组腹腔镜下腹股沟疝修补术124例全部治愈。术式TAPP81例,TEP43例。单侧腹股沟斜疝38例,直疝21例;双侧腹股沟斜疝44例,直疝14例;一侧斜疝一侧直疝5例,双侧腹股沟斜疝并右直疝2例。手术时间40～187min,平均104min。住院时间5～13d,平均7d。随访1个月至33个月,平均随访15个月。手术并发症7例,占5.6%;4例为腹股沟区血肿,其中1例经手术清除后治愈;2例为阴囊气肿,术后第二天自愈;1例直疝术后2个月复发。结论 TAPP/TEP治疗腹股沟疝是安全有效的,并发症及复发率可以接受,规范操作并正确把握手术指征对顺利开展腹腔镜下腹股沟疝修补术具有重要意义。

Objective To explore the clinical effects and complications of laparoscopic inguinal hernia repair. Methods The clinical data, effective rate and complication rate of 124 cases who admitted to our hospital from October 2007 to December 2010 were retrospectively analyzed. Results All 124 cases were operated successfully, 81 patients underwent transabdominal preperitoneal hernia repair （TAPP） and 43 patients were subjected total extraperitoneal hernia repair（TEP）. 38 patients with unilateral indirect inguinal hernia, 21 patients with unilateral direct inguinal hernia, 44 cases with bilateral indirect inguinal hernia and 14 with bilateral direct inguinal hernia, 5 eases were found having unilateral indirect hernia complicated with direct hernia, 2 patients had bilateral indirect inguinal hernia complicated with right direct hernia. Operation time ranged from 40 to 187 minutes, mean 104 minutes. Hospital stay was 5 to 13 days and mean hospital stay was 7 days. All patients were followed up for 1 to 33 months and mean 15 months. 7 cases （5.6%） had complications, 4 cases had inguinal hematoma（ 1 cases underwent operation）, 2 cases suffered from scrotal emphysema, 1 case recurred 2 months after operation. Conclusions TAPP/TEP are an effective and safe procedure to treat inguinal hernia, complication and recurrence rate are acceptable. Standard procedure and correct surgical indication are important for laparoscopie inguinal hernia repair.