腹腔镜完全腹膜外腹股沟疝修补术72例报告

目的 总结完全腹膜外腹腔镜疝修补术(TEP)的临床经验及效果.方法 回顾性分析我院2005年3月至2011年2月采用腹腔镜下完全腹膜外腹股沟疝修补术治疗成人腹股沟疝72例共84侧的临床资料,其中单侧腹股沟斜疝42例,单侧腹股沟直疝18例,双侧腹股沟疝12例;初发疝64例,复发疝8例.结果 72例患者共行84次TEP术,3例中转行经腹腔腹膜前腹腔镜疝修补术(TAPP).手术时间35～155 min,平均73 min,住院时间3～8 d,平均5.5 d.术后并发症5例(侧),占6.9%,均为腹股沟区或阴囊的血肿或血清肿,随访3～63个月,无复发.结论 TEP手术安全可靠,术后疼痛轻、恢复快、复发率低,且费用相对较低、易被患者接受,同其他腹腔镜疝修补术相比优势明显,应成为腹腔镜治疗腹股沟疝的主要术式.

Laparoscopic totalextraperitoneal inguinal hernia repair 72 cases report

Objective To study the successful experience and clinical effectiveness of laparoscopic total laparoscopic extraperitoneal repair (TEP) for inguinal hernia. Methods The clinical data of 72 cases (84 sides) of inguinal hernia treated by Laparoscopic total extraperitoneal hernia repair (TEP) ,from March 2005 to February 2011 in our hospital were retrospectively analyzed. Among the 72 patients,42 patients were with unilateral indirect hernia,18 patients with unilateral direct hernia,and 12 patients with bilateral inguinal hernia operations including 8 recurrent hernia. Results Of the 84 patients with TEP,3 cases were converted from TEP to transabdominal preper- itoneal hernia repair( TAPP) . The operation lasted for 35 to 155minutes with a mean of 73 minutes,and postoperative hospital stay of 3 to 8 days with a mean of 5. 5 days. The common complications were hematom or serom in inguinal area and scrotum,which was observed in 5 cases (6. 9% ) . All the patients were followed up for 3 to 65 months. No recurrence was observed. Conclusions The procedure of Laparoscopic total extraperitoneal hernia repair( TEP) is safe and effective with less pain,faster postoperative recovery,lower recurrence rate and less cost,therefore it is more easily acceptable by patients with inguinal hernia. TEP should be the main laparoscopic procedure for inguinal hernia repair.