腹腔镜完全腹膜外腹股沟疝修补术治疗阴囊疝的临床疗效

Effect of scrotal hernia treated by laparoscopic totally extraperitoneal hernia repair

目的探讨腹腔镜完全腹膜外疝修补术(TEP)中两种不同方式处理阴囊疝疝囊的临床疗效及安全性。方法回顾性分析2017年1月至2019年12月苏州市第九人民医院行完全腹膜外疝修补术治疗阴囊疝65例患者的病例资料。按术中疝囊处理方式不同分为A组(35例)和B组(30例)。A组患者疝囊横断,B组患者疝囊完全剥离。比较2组患者手术时间、术中出血量、术后住院时间及相关并发症发生情况。结果A组手术时间、总并发症发生率均优于B组(P<0.05);2组患者术中出血量、术后住院时间、术后并发症发生率比较,差异均无统计学意义(P>0.05)。术后随访6~24个月,2组均未复发。结论采用TEP术治疗阴囊疝安全有效,且可行。TEP术中采用疝囊横断或疝囊剥离对术中出血量、术后住院时间、术后并发症发生率无影响,可根据患者的实际情况适合选择。疝囊横断手术难度相对较低,手术时间短,术后并发症少,更适合基层医院开展。

Objective To investigate the safety and clinical effect of two different methods of transecting or stripping the hernia sac of scrotal hernia in laparoscopic totally extraperitoneal(TEP)hernia repair.Methods 65 patients with scrotal hernia who underwent TEP from January 2017 to December 2019 in Suzhou Ninth People's Hospital were retrospectively analyzed,they were divided into group A(n=35)and group B(n=30)according to different treatment methods of the hernia sac.In group A,the hernia sac was transected,and in group B,the hernia sac was stripped.The operation time,intraoperative blood loss,postoperative hospital stay and related complications were compared between the two groups.Results The operation time and total complication rate of group A were better than group B(P<0.05).There were no significant differences in the intraoperative blood loss,postoperative hospital stay and postoperative complication rate between the two groups(P>0.05).The patients of the two groups were followed up for 6 to 24 months,and there was no recurrence in both groups.Conclusion Scrotal hernia treated by TEP is safe,effective and feasible.Transecting or stripping the hernia sac during TEP has no effect on the amount of intraoperative blood loss,postoperative hospital stay and incidence of postoperative complications,which can be selected according to the actual situation of patients.Transecting sac of scrotal hernia is relatively easier,which can reduce the operation time and complications.It is more suitable for the primary hospitals.