腹腔镜经腹腔腹膜前疝修补术治疗腹股沟复发疝的临床体会

Laparoscopic transabdominal preperitoneal repair for recurrent inguinal hernia

目的:总结腹腔镜下经腹腔腹膜前无张力疝修补术(transabdominal preperitoneal prosthetic,TAPP)治疗腹股沟复发疝的临床经验及效果。方法:回顾分析2009年3月至2012年1月为113例腹股沟复发疝患者行腹腔镜TAPP的临床资料,其中原位复发疝21例,再发疝92例。结果:112例顺利完成手术,1例中转开放手术。手术时间平均(55.3±16.5)min,平均住院(4.56±2.1)d。术后疼痛发生率4.4%,术后血清肿发生率14.2%,术后异物感发生率1.8%,尿潴留发生率6.2%,无切口感染及其他严重并发症发生。术后随访6～40个月,无再次复发。结论:腹腔镜TAPP治疗腹股沟复发疝具有患者创伤小、并发症少等优势,且后入路修补方式安全性较高,手术效果切实、可靠。

Objective：To summarize the clinical experience and to explore the clinical effect of laparoscopic transabdominal preperitoneal（TAPP） repair for recurrent hernia.Methods：The clinical data of 113 cases of recurrent inguinal hernia treated by laparoscopic TAPP repair from Mar.2009 to Jan.2012 were retrospectively analyzed.There were 21 cases of recurrent hernia and 92 cases of relapse hernia.Results：Operations were completed successfully in 112 cases and 1 case was converted to open surgery.The mean operation time was（55.3±16.5） min,and the mean hospital stay was（4.56±2.1） d.The rate of postoperative pain was 4.4%,the rate of seroma was 14.2%,the rate of foreign body sensation was 1.8%,and the rate of urinary retention was 6.2%.There were no wound infection and other severe complications.Follow-up checkups were made for 6-40 m,and no recurrence was observed.Conclusions：Laparoscopic TAPP repair for recurrent inguinal hernia has advantages of minimal invasion and few complications,and the operation is safe and effective with the posterior approch.