腹腔镜腹股沟疝修补术132例临床分析

Clinical analysis of 132 cases of laparoscopic herniorrhaphy for inguinal hernia

目的:总结腹腔镜疝修补术的手术经验及技巧。方法:回顾分析2005年1月至2010年12月为132例、140例次施行腹腔镜腹股沟疝修补术的临床资料。结果:3例手术由完全腹膜外疝修补术中转为经腹膜前疝修补术,无一例中转开放手术。术后平均住院(5±2.3)d,经腹腹膜前疝修补术和全腹膜外疝修补术手术时间分别为(57.1±18.6)min(、60.0±12.6)min;术后并发症包括6例血清肿3,例暂时性腹股沟区神经感觉异常或轻微疼痛,1例暂时性肠麻痹、不全性肠梗阻,无死亡病例及内脏损伤、切口感染、腹腔感染等并发症发生。术后随访1～3年,无一例复发。结论:腹腔镜疝修补术是安全有效的无张力疝修补术,具有术后复发率、并发症发生率低等优点,适于绝大部分腹部疝的治疗,但术者需具备丰富的腹腔镜手术经验。

Objective：To investigate the operative experience and skills of laparoscopic herniorrhaphy. Methods：The clinical data of 132 patients （140 times） who underwent laparoseopic hernima＇haphy from Jan. 2005 to Dec. 2010 were retrospectively analyzed. Results ： Three cases of totally extraperitoneal prosthbsis were converted to transabdominal preperitoneal prosthesis, and no one was con- vened to open surgery. The average hospital stay was （5±2.3 ） d. Mean operation time of transabdominal preperitoneal prosthesis was （57.1±18.6 ） rain, totally extraperitoneal prosthesis was （ 60.0 12.6） rain. Postoperative complications included 6 cases of seroma, 3 cases of temporary inguinal paraesthesia or mild pain, and 1 case of temporarily enteroparalysis, incomplete intestinal obstruction. No death and no complications such as visceral injury, incision and abdominal infection occurred. No recurrence was found during the 1-3 years＇follow-up. Conclusions：Laparoscopie hernia repair is safe, effective and tension-free, has advantages of less postoperative compli- cations and recurrence rate. This procedure is suitable for most abdominal hernia by seasoned laparoscopie surgeon.