基层医院腹腔镜全腹膜外疝修补术治疗腹股沟疝的临床体会

Clinical experience of primary hospital laparoscopic total extraperitoneal herniorrhaphy for inguinal hernia

目的总结腹腔镜全腹膜外疝修补术治疗68例腹股沟疝在基层医院的实践经验。方法选择2010年01月-2012年05月我院68例成年人Ⅰ～Ⅲ型腹股沟疝患者行TEP手术的临床资料，分析手术的临床效果、术后并发症以及患者的接受情况。结果全部病例经手术治疗痊愈。术后恢复良好，无明显疼痛，无切口感染。术中发生合并症7例，包括出血2例，穿破腹膜2例，皮下气肿3例，均未影响手术；术后2年复发1例，再次手术后痊愈。结论腹腔镜行全腹膜外疝修补术可在基层医院推广；由于基层医院多为劳动农民，建议补片固定为妥。

Objective To summarize experience of laparoscopic total extraperitoneal hernioplasty in 68 patients with inguinal hernia. Method The clinical data of 68 cases with inguinal hernia from Jan 2010 to May 2012 were analyzed retrospectively. All patients underwent laparoscopic total extraperitoneal herniorrhaphy （TEP） and the clinical efficacy was recorded. Results All patients were cured by TEP approach. Intraoperative complications happened in 7 cases, including bleeding in 2 cases, peritoneum perforated in 2 cases, subcutaneous emphysema in 3 cases. No pain and infection occurred after operation. Inguinal hernia recurrence was in one case in 2 years after operation and the patient was cured by reoperation. Conclusion TEP procedure can be performed in basic hospital. For most farmer patients, the patch had better to be properly fixed during operation.