腹腔镜探查联合TEP在嵌顿性腹股沟疝的应用

The application of laparoscopic exploration combined with TEP for incarcerated inguinal hernia

目的探讨腹腔镜腹腔探查联合TEP在嵌顿性腹股沟疝中应用的可行性及安全性。方法 2010年3月至2014年11月我科共收治嵌顿性腹股沟疝23例,其中21例手法复位失败后行腹腔镜腹腔探查,治疗原则如术中未见肠管坏死等情况,则行TEP,放置聚乙烯补片。若肠管坏死则中开腹。结果 23例行腹腔镜腹腔探查,2例发现肠管坏死而中转开放手术;共19例实施TEP,TEP结束后再次探查腹腔未见肠管缺血加重。术后未见并发症发生,随访至今未见复发。结论腹腔镜腹腔探查判断疝内容物活力后改行TEP在治疗嵌顿性腹股沟疝上是安全、可行的。

Objective To investigate the feasibility and safety for patients with incarcerated inguinal hernia who treated by laparoscopic exploration combined with laparoscopic total extraperitoneal（TEP）.Methods Twenty-three patients with incarcerated inguinal hernia were treated in our hospital from March 2010 to November 2014.Of them,21 cases were performed by manipulative reduction and failed.Principle of management of laparoscopic exploration combined with TEP was performed when bowel was in good condition,and those found bowel necrosis were transferred open operation.Results Nineteon cases were performed TEP and no complications occurred after operation.Two cases were treated by open inguinal herniorrhaphy due to bowel necrosis.Conclusion Laparoscopic exploration combined with TEP is safe and feasible for management of acute incarcerated inguinal hernia under definite evaluation of intestinal ischemia and intestinal necrosis.