腹腔镜疝囊内环口关闭法治疗成人腹股沟疝

The efficacy of laparocopic management of indirect inguinal hernia

目的 探讨腹腔镜疝囊高位结扎自体组织关闭内环口方法对成人腹股沟疝的治疗效果。方法 回顾分析 2 0 0 0年 11月至 2 0 0 2年 2月腹腔镜疝囊高位结扎、内环口关闭法治疗 17例成人腹股沟斜疝的手术后恢复情况及随访结果并与传统手术治疗 12例成人腹股沟斜疝的结果相比较。 结果 手术时间 :腹腔镜手术组 (89 9± 2 5 8)分钟 ,传统手术组 (6 3 5± 2 2 4 )分钟 (t=2 86 12 ,P <0 0 1) ;平均住院天数 :腹腔镜手术组 (6 2± 2 1)天 ,传统手术组 (9 5± 2 6 )天 (t =3 7779,P <0 0 1) ;平均下床活动时间 :腹腔镜手术组 (1 5± 0 8)天 ,传统手术组 (3 6± 1 1)天 (t=5 96 38,P <0 0 1) ;术后疼痛反应 :腹腔镜手术组 11 76 % (2 17) ,传统手术组 75 % (9 12 ) (χ2 =11 94 76 ,P <0 0 1) ;阴囊水肿 :腹腔镜手术组 11 76 %(2 17) ,传统手术组 5 0 % (6 12 ) (χ2 =5 14 81,P <0 0 5 )。随访 (6～ 14 )个月 ,传统手术组 1例复发 ,腹腔镜手术组无复发。 结论 腹腔镜疝囊高位结扎、内环口封闭治疗成人腹股沟斜疝是安全有效的。

Objective The effects of laparoscopic management of indirect ingunal hernia in adults were studied. Methods 17 patients with indirect inguinal hernia underwent laparoscopic high ligation of hernial sac and 12 patients with indirect inguinal hernia underwent traditional hernial repair between November 2000 to February 2002.The outcomes of two groups were compared retrospectively. Results Comparison between laparoscopic and open group showed that the operating time was (89 9±25 8)min vs(63 5±22 4)min( t =2 8612, P <0 01);hospital stay (6 2±2 1) days vs (9 5±26) days ( t =3 779, P <0 01);average time of off-bed (1 5±0 8) days vs (3 6±1 1) days( t =5 9638, P <0 01);postoperative response of pain 11 76%(2/17)vs 50%(6/12)(χ 2=5 1481, P <0 05).There was no recurrent patient in laparoscopic but one in open group after (6～14) months' follow-up. Conclusions The laparoscopic high ligation of hernial sac and enhance is secure and useful for indirect inguinal hernia in adults.