腹腔镜经腹腹膜前疝修补术治疗复发性腹股沟疝的疗效

目的探讨腹腔镜经腹腹膜前疝修补术（trans-abdominal preperitoneal hernia repair，TAPP）治疗复发性腹股沟疝的临床应用。 方法回顾性分析2013年1月至2018年6月，大理大学第一附属医院收治的25例复发性腹股沟疝患者的临床资料，所有患者均行TAPP术式。 结果25例患者TAPP手术均获得成功，均为腹膜前修补，无中转开放手术。手术时间30～70 min，平均（52.74±8.26）min。术中出血量为2～7 ml，平均（5.14±0.87）ml。术后留置导管患者1例，4 d后拔除导尿管，恢复自主排尿；出现阴囊血清肿患者2例，其中未处理10 d后自行吸收1例，经穿刺抽吸1次后治愈1例；所有患者均未见明显切口疼痛；均未出现切口感染、神经痛、肠梗阻及其他严重并发症。术后恢复良好，均于术后1～2 d开始下床活动，平均（0.93±0.51）d，住院时间为3～6 d，平均（3.17±0.78）d。所有患者均随访5～36个月，平均（16.79±4.36）个月，未出现补片感染、再次复发、持续性疼痛等情况。 结论TAPP具有手术时间短、术中出血量少、术后恢复快、并发症少等优势，是治疗复发性腹股沟疝的有效方法。

Application value of laparoscopic of transabdominal preperitoneal hernia repair in the treatment of recurrent inguinal hernia

ObjectiveTo explore the application value of laparoscopic of transabdominal preperitioneal hernia repair (TAPP) in the treatment of recurrent inguinal hernia. MethodsThe clinical data of 25 patients with recurrent inguinal hernia admitted to the First affiliated hospital of Dali University from January 2013 to June 2018 were retrospectively analyzed, and all patients underwent TAPP. ResultsAll patients were completed successfully by TAPP operation, which were all preperitoneal repair, and none was converted to open operation. The operation time was 30 to 70 minutes, the average time was (52.74±8.26) minutes. The intraoperative blood loss was 2 to 7 ml, the average blood loss was (5.14±0.87) ml. After operation, 1 case patient had indwelling catheter, and the catheter was removed in 4 days after operation to restore spontaneous micturition. There were 2 patients with scrotal seroma, 1 patient was self-absorbed in 10 days after operation without treatment, and 1 patient was cured after one time of puncture and drainage; No obvious incisional pain was founded. The postoperative recovery was good, and all got out of bed on 1 to 2 days after operation, and the average time was (0.93±0.51) days, the hospitalization time was 3 to 6 days, the average time was (3.17±0.78) days. All patients were followed up for 5 to 36 months, the average time was (16.79±4.36) months. There was no patch infection, recurrence and persistent pain, etc. ConclusionTAPP is an effective treatment for recurrent inguinal hernia due to its advantages of short operation time, less intraoperative blood loss, rapid postoperative recovery and less complications.