完全腹膜外腹腔镜补片植入术治疗腹股沟复发疝33例分析

Clinical analysis of laparoscopic totally extraperitoneal patch implantation (TEP) for treating recurrent inguinal hernia in 33 cases

目的 探讨完全腹膜外腹腔镜补片植入术（TEP）治疗腹股沟复发疝及手术技巧.方法 回顾性分析2010年1月～2013年1月我院实施TEP的33例患者的临床资料,并归纳总结手术技巧.结果 手术均获成功,没有中转其他术式,平均手术时间为（75.1±38.5） min,术中出血量为（9.5±3.0）mL,腹膜撕裂发生3例,平均住院时间为（5.1±1.5）d,术后皮下气肿发生1例,术后没有发生持续性神经性疼痛、腹股沟区血肿、补片感染和切口感染的情况;1例术后5月复发.结论 本术式对治疗复发性腹股沟疝是一种安全和有效的手术方法,有较低的复发性疝术后的再复发率.

Objective To evaluate laparnscopic totally extraperitoneal patch implantation （TEP） for treating recurrent inguinal hernia and summarizing the experience. Methods From January 2010 to January 2013, clinical data of 33 cases undergoing TEP in our hospital were retrospectively analyzed and operation skills were summarized. Results All the operations were successfully completed, and no patients were transferred to open operation. Average operation time was （75.1±38.5） min, intraoperative blood loss was （9.5±3） mL, the average hospitalization time was （5.1± 1.5） d. The complications had peritoneal laceration in 3 cases, subcutaneous emphysema in 1 ease. No persistent postoperative neuropathic pain, groin hematoma, infection of incisional wound. All patients were followed up in a period of one to nine months. The recurrence occurred in one case 5 months after operation. Conclusion This surgical procedure is a safe and effective operative method in the treatment of recurrent inguinal hernia,and it would reduce significantly postoperative re-recurrent rate for recurrent hernia.