经腹腹膜前疝修补术治疗复发腹股沟疝的临床效果

Clinical effect of recurrent inguinal hernia treated by trans-abdominal preperitoneal hernia repair

目的探讨复发腹股沟疝的腹腔镜手术体会及临床效果。方法选取2022年10月至2023年9月六安市人民医院收治并手术的复发腹股沟疝患者的临床及术后随访资料。筛选其中再次手术方式为腹腔镜经腹腹膜前疝修补术(TAPP)的30例患者的临床资料,记录临床及随访数据,包括性别、体重指数等基本信息,临床数据包括两次手术间隔时间、手术方式、复发疝类型、手术出血量等,随访数据包括术后疼痛等。结果30例患者手术均成功并得到有效随访,均无复发情况,手术方面其中1例为联合开放杂交术式。再次手术术后早期疼痛12例,长期慢性疼痛1例,血清肿3例,血肿1例。结论针对复发腹股沟疝,选择TAPP术式可有效避免既往手术入路导致的解剖区域粘连不清,同时手术经腹腔镜途径探查,对复发原因的分析更加直观,补片能更大程度的覆盖耻骨肌孔,对于术后疼痛等方面也有良好的临床效果。

Objective To investigate the experience and clinical effect of laparoscopic surgery for recurrent inguinal hernia.Methods The clinical and postoperative follow-up data of patients with recurrent inguinal hernia admitted and operated in Lyu'an People's Hospital from October 2022 to September 2023 were selected.The clinical data of 30 patients who underwent laparoscopic trans-abdominal preperitoneal hernia repair(TAPP)were screened.The clinical and follow-up data were recorded,including basic information such as name,gender,BMI;the clinical data such as the interval between two operations,surgical method,type of recurrent hernia,surgical bleeding,and follow-up data including postoperative pain,etc.Results All 30 patients were successfully operated and effectively followed up without recurrence.One of them was operated by combined open hybridization method.There were 12 cases of early postoperative pain after reoperation,1 case of long-term chronic pain,3 cases of seroma and 1 case of hematoma.Conclusion For recurrent inguinal hernia,the TAPP procedure can effectively avoid the unclear adhesion in the anatomical area caused by previous surgical approaches.At the same time,the analysis of the cause of recurrence is more intuitive through laparoscopic exploration,and the mesh can cover the myopectineal orifice to a greater extent,which also has a good clinical effect on the postoperative pain and other aspects.