腹腔镜疝囊高位结扎及脐内侧襞加强修补腹股沟疝的实验研究

Experimental study of laparoscopic high ligation of hernia sac with lateral umbilical fold reinforcement for inguinal hernia repair

目的:通过动物实验研究观察腹腔镜疝囊高位结扎+脐内侧襞加强术修补腹股沟疝的安全可行性。方法:将健康新西兰雄兔(先天性双侧内环口未闭合)64只,随机均分为实验组与对照组,实验组行腹腔镜右侧疝囊高位结扎+脐内侧襞加强术,对照组行腹腔镜右侧疝囊高位结扎术;两组分别于术后第7、15、30、60天各随机取8只进行腹腔观察,及修补侧内环口的抗腹压能力测量。结果:实验期内无动物死亡。术后两组兔均无腹腔内并发症发生,实验组脐内侧襞与原腹膜融合良好。两组兔在术后修补侧腹股沟区承受抗腹压值均随时间延长而不断升高,且均在术后30 d基本达最高,但实验组术后各时间点的抗腹压值均明显高于对照组(均P<0.05)。结论:腹腔镜疝囊高位结扎+脐内侧襞加强术修补兔腹股沟疝是安全有效,可为临床推广提供实验依据。

Objective： To observe the safety and feasibility of laparoscopic high ligation of the hernia sac with lateral umbilical fold reinforcement in inguinal hernia repair through an animal experiment. Methods： Sixty-four healthy male New-Zealand rabbits （having congenital defect at the internal inguinal ring） were randomized into experimental group and control group. Rabbits in experimental group received laparoscopic right high ligation of the hernia sac with lateral umbilical foldj while those in control group underwent laparoscopic right high ligation of the hernia sac only. On postoperative day （POD） 7, 15, 30, and 60 respectively, 8 rabbits in either group were randomly picked up to observe the abdominal conditions under laparoscope and then to determine the level of anti- abdominal pressure at the repaired internal inguinal ring. Results： No animal death occurred during the experiment. No intra-abdominal complication was observed in either of the groups, and the lateral umbilical fold was well integrated with the original peritoneum in rabbits of experimental group. After operation, the level of anti-abdominal pressure at the repaired inguinal region in both groups of rabbits were continuously increased as time went on, and both approximately reached a maximum on POD 30, but the level of anti-abdominal pressure at each predefined postoperative time point in experimental group was significantly higher than that in control group （all P〈0.05）. Conclusion： Laparoscopic high ligation of the hernia sac with lateral umbilical fold reinforcement for inguinal hernia is safe and effective in rabbits, which may provide an experimental basis for its clinical use.