腹腔镜下男性腹股沟区的测量及其临床意义

Laparoscopic measurement of the inguinal region of male patients and its clinical significance

目的:通过腹腔镜下对国人腹股沟区进行测量,了解国人腹股沟区的解剖结构特点及其与身体参数、疝类型之间的相关性,为临床补片大小的选择提供理论依据及数据支持。方法:于腹腔镜全腹膜外腹股沟疝修补/腹腔镜经腹腹膜前腹股沟疝修补术中测量男性初发腹股沟疝患者的腹股沟区数据,共测量149例、243侧。术中以内环口内侧为中心,分别测量其至髂前上棘、耻骨结节、腹壁下动脉与腹直肌的交点(直疝三角顶点)及耻骨梳韧带的距离。结果:以内环口内侧为中心,其至髂前上棘的距离为(6.1±0.9)cm,至耻骨结节的距离为(4.8±0.7)cm,至直疝三角顶点距离为(4.3±0.8)cm,至耻骨梳韧带距离为(3.2±0.5)cm。不同类型的疝(直疝及斜疝)除内环口至髂前上棘的距离外,余差异均无统计学意义(P>0.05),髂前上棘至耻骨结节之间的距离差异无统计学意义[直疝(10.9±0.9)cm vs.斜疝(10.9±0.9)cm]。左右两侧的测量数据差异无统计学意义(P>0.05)。结论:根据测量数据,建议国人行腹腔镜腹股沟疝腹膜前修补术时使用的补片为14 cm×12 cm大。

Objective:Few inguinal area data is available at present for Chinese population.The aim of this study is to explore if there is any correlation between anatomical characteristics of Chinese population with body parameter and hernia types by measuring inguinal region size of Chinese population under laparoscopy,in order to provide theoretical basis and data support for choice of clinical patch size.Methods:Inguinal area data of 149 male patients(243 sides)with primary inguinal hernia were measured in laparoscopic totally extraperitoneal or transabdominal preperitoneal repair.The measuring method was taking inside of inner ring orifice as the center,and collecting the distance from the center to the anterior superior iliac spine,the pubic tubercle,the intersection of the inferior epigastric artery with the rectus abdominis(the apex of the triangle of the direct hernia)and the pectineal ligament.Results:With the inside of inner ring orifice as center point,the distance from the anterior superior iliac spine to it was(6.1±0.9)cm,from the pubic tubercle to it was(4.8±0.7)cm,from the triangular apex of the direct hernia to it was(4.3±0.8)cm,and from the pectineal ligament to it was(3.2±0.5)cm.Except the distance between inner ring orifice and anterior superior iliac spine,there was no statistical difference observed in above data between different types of hernia(direct inguinal hernia and indirect inguinal hernia,P>0.05).And there was no statistical difference in distance from anterior superior iliac spine to pubic tubercle between inguinal hernia and indirect inguinal hernia[(10.9±0.9)cm vs.(10.9±0.9)cm,P>0.05].No statistical difference was found between left and right side(P>0.05).Conclusions:Based on the measurements,the size of the mesh recommended for laparoscopic inguinal hernia repair is 14 cm×12 cm for Chinese population.