腹腔内网片植入法在复发性腹股沟疝再手术中的应用

The application of IPOM in re-operation of recurrent inguinal hernia

目的探讨腹腔镜下腹腔内网片植入法（IPOM）在复发性腹股沟疝再手术中的应用价值。方法对2007年1月-12012年1月间收治的159例复发性腹股沟疝患者临床资料进行回顾性分析。结果开放手术78例。平均手术时间（90．4±11．5）分，平均住院时间（6．2±1．3）天，平均住院费用（9101±581）元，术后随访10～59个月6例复发；IPOM手术81例，平均手术时间（25．1±9．5）分；平均住院时间（4．3±0．7）天，平均住院费用（13674±893）元，术后随访10～58个月1例复发；两组患者术后均未出现肠梗阻、窦道形成和肠瘘等严重并发症。结论相比开放手术方式，IPOM在复发性腹股沟疝的再手术中，具有操作简单、复发率低的优点。

Objective . To investigate the value of laparoscopic intraperitoneal onlay mesh （IPOM） in re-operation of recurrent inguinal hernia. Methods Clinical datum of 159 male patients who had undergone surgical repair of recurrent ingui- nal hernias from January 2007 through January 2012 were analyzed retrospectively. Results The review showed that 159 pa- tients had undergone either open mesh repair （ n = 78 ） or laparoscopic IPOM repair （ n = 81 ） for recurrent inguinal hernia. 78 cases underwent open mesh repair, and 81 cases received laparoscopic IPOM. Although the overall cost in IPOM group （ 13674 ±893 yuan） was higher than open mesh group （9101 ±581 yuan）, mean operation time （90. 4 ±11.5 vs 25.1 ±9. 5 minutes, P = 0. 002） and mean hospital stay （6.2±1.3 vs 4. 3 ±0.7 days, P = 0.03 ） were much longer in open mesh group. There were 1 （ 1.2% ） re-recurrence in IPOM group and 6 （7. 6% ） re-recurrences in open mesh group after 10- 59 months follow up. There were no severe complications in both groups. Conclusion Compared with open mesh repair, laparoscopic IPOM has its own advantages including easier to manipulation, faster for healing and lower re-recurrent rate.