嵌顿性闭孔疝的早期诊断及腹腔镜治疗体会

arly diagnosis and laparoscopic treatment of incarcerated obturator hernia

目的总结嵌顿性闭孔疝的诱因、早期诊断要点及一期腹腔镜经腹腹膜前疝修补术(TAPP)的注意事项。方法回顾性分析2015年6月至2020年5月,北京市垂杨柳医院收治5例嵌顿性闭孔疝患者的临床资料。结果5例患者均为老年女性,均为小肠嵌顿,1例患者因术前延误诊断,导致患者死亡;其余4例早期确诊患者行TAPP,术后恢复良好,痊愈出院。结论嵌顿性闭孔疝进展凶险,仔细的病史采集、严格的体格检查及CT辅助检查,可以早期诊断。在早期诊断基础上,腹腔镜探查及一期TAPP安全有效。

Objective To summarize the causes of incarcerated obturator hernia,the key points of early diagnosis and the matters needing attention of one-stage laparoscopic tension-free preperitoneal repair.Methods The clinical data of 5 patients with incarcerated obturator hernia in Beijing Chuiyangliu Hospital from June 2015 to May 2020 were retrospectively analyzed.Results The 5 patients with intestinal incarceration were all elderly women,and 1 patient died due to delayed preoperative diagnosis.The other 4 patients with early diagnosis completed laparoscopic exploration and transabdominal preperitoneal(TAPP)tension-free repair,and recovered well after the operation.Conclusion Incarcerated obturator herniahas a dangerous progression,and can be diagnosed early by careful history collection,rigorous physical examination and CT examination.Based on early diagnosis,laparoscopic exploration and one-stage TAPP repair are safe and effective.