猪小肠黏膜下层脱细胞基质材料生物补片在腹腔镜经腹腹膜前疝修补术中的应用

Laparoscopic transabdominal preperitoneal repair of inguinal hernia using small intestine submucosa mesh

目的探讨腹腔镜经腹腹膜前疝修补术（TAPP）中应用猪小肠黏膜下层脱细胞组织基质（SIS）补片的临床效果及应用价值。方法回顾性分析2014年1月至2015年2月,首都医科大学附属北京朝阳医院在TAPP疝修补术中使用SIS补片治疗21例腹股沟疝患者的相关临床资料,观察患者术后并发症及复发情况。结果 21例患者均顺利完成手术,无中转开腹情况,手术时间为33-62 min,平均（44±8）min;住院时间2-7 d,平均（3.5±1.5）d;术后24 h疼痛视觉模拟评分（VAS）2-4分,平均（2.6±0.9）分;术后出现低热1例;血清肿3例;未出现切口感染、肠梗阻及其他严重并发症。21例患者均获随访,术后随访时间为10-23个月,平均（13±4）个月,无术后慢性疼痛及异物感,无复发患者。结论腹腔镜TAPP疝修补术中应用SIS补片是一种安全可行的手术方式,它具有创伤小、并发症少、术后舒适性好等优势,且不增加术后复发风险,特别适合年轻有生育要求的腹股沟疝患者。

Objective To explore the value and the clinical effect of laparoscopic transabdominal preperitoneal（ TAPP） hernia repair with small intestine submucosa（ SIS） mesh. Methods Clinical data of21 cases of inguinal hernia who underwent laparoscopic TAPP hernia repair with SIS mesh from January 2014 to February 2015 in Beijing Chao-Yang Hospital of Capital Medical University were retrospectively analyzed.Postoperative complications and recurrences were recorded. Results Operations were completed successfully in all 21 cases and none was converted to open surgery. The mean operation time was（ 44 ±8） minutes（ range 33 to 62 minutes） and the mean hospital stay was（ 3. 5 ± 1. 5） days（ range 2 to7 days）. The postoperative VAS pain score were（ 2. 6 ± 0. 9） scores（ range 2 to 4 scores）; there were 1patient suffered fever and 3 patients suffered scrotal seroma. There were no complications such as wound infection and intestinal obstruction after operation. All cases were followed up for 10 to 23 months（ mean of13 ± 4 months） without obvious chronic pain,foreign body sensation and recurrence. Conclusion Laparoscopic TAPP repair of inguinal hernia using small intestine submucosa mesh is safe and feasible,and has the advantages of minimal invasion,few complications and good postoperative comfortable feeling,without increasing the risk of recurrence. This technique is especially suitable to young patients with inguinal hernia who have the requirement of fertility.