腹腔镜腹股沟疝修补术中血管损伤的预防与处理

Prevention and treatment of vascular injury in laparoscopic inguinal hernia repair

目的:探讨腹腔镜腹股沟疝修补术中血管损伤的预防与处理方法。方法:回顾分析2015年5月至2019年5月20例腹腔镜腹股沟疝手术中血管损伤患者的临床资料。观察术中、术后血管并发症发生情况及处理措施;出院后30 d采用电话方式随访,了解患者一般情况、症状及后续治疗。随访时间截至2019年6月。结果:20例患者中,精索血管损伤5例,输精管动脉损伤3例,腹壁下血管4例,死亡冠血管3例,股静脉2例,耻骨后静脉丛3例。术中均止血成功。术后随访1个月,均无出血或血栓形成。结论:腹腔镜腹股沟疝修补术中出现的血管损伤,重在预防,一旦发生,积极采取不同的处理方式可取得较好的治疗效果。

Objective:To explore the methods of prevention and treatment of vascular injury in laparoscopic inguinal hernia repair.Methods:The clinical data of 20 patients with vascular injury in laparoscopic inguinal hernia repair from May 2015 to May 2019 were analyzed retrospectively.The occurrence and treatment of vascular complications during and after operation were observed,and the patients were followed up by telephone for 30 d after discharge to record the general condition,symptoms and follow-up treatment.Follow-up period was up to Jun.2019.Results:Among the 20 patients,spermatic vascular injury was detected in 5 cases,deferential artery was injured in 3 cases,4 cases with inferior epigastric vascular injury,3 cases with corona mortis vascular injury,2 cases with femoral vein injury and 3 cases with retropubic venous plexus injury.All of them were treated successfully in operation.The patients were followed up for 1 month,and none suffered from hemorrhage or thrombosis.Conclusions:Surgeons should focus on preventing vascular injury in laparoscopic inguinal hernia repair.Once it occurs,better treatment results can be achieved by active adopting different treatment methods.