急腹症腹腔镜探查发现隐匿性疝的处理经验总结

Experience of occult inguinal hernia in laparoscopic exploration of acute abdomen

目的探讨急腹症患者发现的腹股沟隐匿性疝的处理方法和技巧。方法总结2008年8月至2010年10月，济宁市第一人民医院收治的急腹症行急诊腹腔镜探查患者313例，术中发现隐匿性腹股沟疝41例。同期行腹股沟无张力疝修补术46例。结果围手术期患者无明显腹股沟不适症状，感染1例。术后随访3～5年，行内环口高位结扎2例患者出现复发。同期行腹股沟无张力疝修补术患者复发2例，感染2例。二组复发率比较差异无统计学意思（x^2=0．01，P〉0．05），感染率差异无统计学意义（x^2=0．2，4，P〉0．05）。结论急腹症腹股沟区发现的隐匿性斜疝行内环口高位结扎＋自体组织修补是可行的。

Objective To explore the management of occult inguinal hernia found in patients with acute abdomen. Methods From August 2008 to October 2010, there were 313 cases of acute abdomen underwent emergency laparoscopie exploration in Jining First People＇s Hospital. 41 cases of occult inguinal hernia were found in the operations. The tension-free hernia repair was performed simultaneously in 46 patients. Results In the perioperative period, patients had no obvious symptoms in groin area. Infection occurred in 1 case. Patients were followed up for 3 to 5 years. Only two cases of high ligation of inner ring had hernia recurrence. Meanwhile, 2 cases of recurrence and 2 cases of infection were observed in patients with tension-free hernia repair. There were no significant difference in recurrence and infection between the two groups （x^2 = 0. 01,0. 24, P 〉 0. 05）. Conclusion Both high ligation of inner ring and tensionfree hernia repair with self-tissue were feasible methods for occult inguinal hernia found in acute abdomen cases.