经腹部分腹膜外修补术治疗腰疝12例临床研究

Transabdominal partial extraperitoneal repair of lumbar hernia:A clinical study of 12 patients

目的探讨经腹部分腹膜外修补术(TAPE)治疗腰疝的安全性和有效性。方法回顾性分析上海交通大学医学院附属瑞金医院普外科2009年5月至2013年7月行TAPE治疗的12例腰疝病人的临床资料。结果疝缺损面积为(81.3±43.9)cm2,补片面积为(266.7±103.0)cm2。手术无中转,手术时间为(60.3±10.4)min,术中无并发症发生。术后无病人使用镇痛剂,术后第1天(POD1)和术后第3天(POD3)的视觉模拟疼痛评分(VAS)分别为3.9±0.7和2.7±0.6。术后住院时间为(5.0±1.4)d,2周内均恢复非限制性活动。随访期间无复发,亦无并发症发生。结论短期疗效显示,TAPE是治疗腰疝的一种安全、有效的微创技术。

Objective To explore the safety and effectiveness of transabdominal partial extraperitoneal （TAPE） repair of lumbar hernia. Methods The clinical data of 12 patients with lumbar hernia underwent TAPE repair between May 2009 and July 2013 in Ruijin Hospital,Shanghai Jiao Tong University School of Medicine were analyzed retrospectively. Results The average size of the hernia defect was （81.3±43.9） cm2. The average size of the mesh employed was （266.7± 103.0） cm2. There was no conversion to open surgery. The mean surgical time was （60.3 ± 10.4） minutes. No intra-operative complications occurred. No patients need to take analgesic postoperatively. The mean VAS were 3.9 ± 0.7 and 2.7 ± 0.6 on the first day and the third day after surgery （POD1 and POD3） respectively. The mean postoperative hospitalization was （5.0 ± 1.4） days. All patients returned to unrestricted activity within two weeks after surgery. During the follow-up period,no recurrence and complications were observed. Conclusion TAPE is a novel laparoscopic technique with safety and effectiveness for lumbar hernia repair. Its efficacy in short-term is certain.