疝囊顶入路腹股沟区腹水疝腹膜前无张力修补术的临床应用

Clinical Application of Preperitoneal Approach Inguinal Hernia Repair by Hernia Sac Top Pathway for the Patient with Ascites

目的 探讨疝囊顶入路对腹股沟区腹水疝腹膜前无张力修补术的临床应用价值。方法 对2010年1月～ 2013年11月收治的7例腹股沟区腹水疝的病例应用疝囊顶入路腹膜前无张力修补术进行腹膜前疝无张力修补。术中放置腹腔引流管和切口下负压吸引装置。结果 所有病例术中及术后腹腔积液均得以有效控制,手术全部顺利完成,平均手术时间60min,术后无明显并发症发生,包括阴囊血肿、疝复发、修补区膨出、严重疼痛等。结论 疝囊顶入路腹膜前疝无张力修补术由于保持了腹横筋膜的完整性,所以能有效的治疗腹股沟区腹水疝,是治疗腹股沟区腹水疝的一种新的可靠选择。

Objective To describe and investigate the clinical experience of preperitoneal approach repair for inguinal hernia combined with ascites by hernia sac top pathway.Methods The clinical dates of the patients with inguinal hernia combined with ascites （7cases） from Jan 2010 to Nov 2013 in First People＇s Hospital of Hangzhou were couected.All patients underwent preperitoneal approach inguinal hernia repair by HST pathway successfully.Abdominal drainage tube was put in the pelvic cavity in the operation.And negative pressure suction device was put under subcutaneous postoperative.Results The abdominal ascites of the patients were under control in the operation and postoperative effectively.All operations by HST pathway completed successfully.No any serious complications including scrotum hematoma,hernia re-emerge,chronic pain etc.were found.The average operative time was about 60 min.All patients feel satisfied and comfortable.Conclusion Preperitoneal approach repair for inguinal hernia combined with ascites by hernia sac top pathway is a reliable and safe new way,because it keeps the integrity of the transverse fascia.We suggest HST pathway is a good choice of inguinal hernia repair for the patients combined with ascites.