腹腔镜完全腹膜外疝修补术207例临床研究

Laparoscopic totally extraperitoneal hernia repair: A clinical study of 207 cases

目的探讨腹腔镜完全腹膜外疝修补术(laparoscopic totally extra-peritoneal,TEP的安全性及临床疗效。方法回顾性分析2012年1月至2016年7月,南京医科大学附属南京医院行TEP并应用3D补片及免固定方法的腹股沟疝207例患者的临床资料。结果 179例单侧疝及28例双侧疝患者均成功施行TEP手术,单侧手术时间30～100min,平均(51.8±10.7)min,双侧疝手术时间55～130 min,平均(92.2±18.8)min;术中出血量5～20 ml,平均术后住院(2.1±0.5)d;术后并发症:尿潴留4例(1.9%)、阴囊气肿2例(1%)、血清肿10例(4.8%)、暂时性神经感觉异常1例(0.5%)。术后随访16～60个月,复发1例(0.5%)。结论 TEP应用3D补片及免固定技术是一种安全、有效的腹股沟疝修补方式。

Objective To investigate the safety and clinical outcomes of laparoscopic totally extraperitoneal repair(TEP) of hernia. Methods The data of 207 patients received TEP with 3 D mesh and no-fixation method were analyzed retrospectively from January 2012 to July 2016. Results 179 patients with unilateral hernia and 28 patients with bilateral hernias received the TEP successfully. The operative time of unilateral or bilateral hernia repair were 30 to 100 minutes [mean(51.8±10.7) minutes]and 55 to 130 minutes [mean(92.2±18.8) minutes], respectively. The blood loss during operation was 5 to20 ml, and the average postoperative hospital stay was(2.1±0.5) days. The postoperative complications included 4 urinary retention(1.9%), 2 pneumoscrotum(1%), 10 seroma(4.8%), and 1 transient neuropraxia(0.5%). Following up for 16 to 60 months, there was 1 recurrent case(0.5%). Conclusion TEP with 3 D mesh and no-fixation method is a safe and efficient inguinal hernia repair method.