腹腔镜探查联合李金斯坦修补术治疗难复性阴囊疝27例临床疗效观察

Observation on the clinical efficacy of laparoscopic approach combined with Lichtenstein hernioplasty in the treatment of 27 cases of refractory scrotal hernia

目的总结腹腔镜联合李金斯坦修补术治疗难复性阴囊疝患者的临床疗效和评价。方法回顾性分析2017年6月—2019年6月本院胃肠外科收治的27例难复性阴囊疝患者临床资料,患者均采用腹腔镜联合李金斯坦修补术,总结分析患者术中情况、术后并发症及复发率等。结果27例患者全部顺利完成手术,手术时间40~80 min,平均(55.77±7.43)min,术中出血量10~30 ml,平均(18.85±5.06)ml,拔管时间1~2天,平均(1.58±0.49)天;术后下床活动时间1~2天,平均(1.12±0.32)天;住院天数2~4天,平均(3.58±0.69)天。患者术后出现血清肿1例,无慢性疼痛、切口积液、腹股沟区麻木感、阴囊血肿、尿潴留、肠梗阻及睾丸萎缩并发症。术后随访6~30个月,无复发、无补片感染发生。结论腹腔镜联合李金斯坦修补术治疗难复性阴囊疝安全可行,临床疗效较好。

Objective To summarize the clinical efficacy of laparoscopic approach combined with Lichtenstein hernioplasty in the treatment of refractory scrotal hernia and evaluation on it.Methods The clinical data of 27 patients with refractory scrotal hernia,those admitted to the gastrointestinal surgery department in Tianjin Nankai hospital,from June 2017 to June 2019,were analyzed retrospectively.All patients were treated with laparoscopy combined with Lichtensteinhernioplasty.Intraoperative situations,postoperative complications and recurrence rate were compared.Results The operations were successfully completed in all the 27 cases.The operation time was 40-80 min,with an average of(55.77±7.43)min.The intraoperative blood loss was 10-30 ml,with an average of(18.85±5.06)ml.The extubation time was 1-2 days,with an average of(1.58±0.49)days.Postoperative out-of-bed activity lasted 1-2 days,with an average of(1.12±0.32)days.The length of hospitalization was 2-4 days,with an average of(3.58±0.69)days.While there was 1 case of seratoma after operation.None chronic pain,incision effusion,numbness in the inguinal area,scrotal hematoma,urinary retention,intestinal obstruction and testicular atrophy occurred.After operation,the patients were followed up for 6 to 30 months,with no recurrence or patch infection.Conclusions Laparoscopy combined with Lichtensteinhernioplasty is safe and feasible in the treatment of refractory scrotal hernia,with good clinical efficacy.