局麻下网塞腹膜前修补术在腹股沟疝中的应用

目的探讨在局麻下网塞腹膜前修补术治疗腹股沟疝的临床价值。方法局麻下将网塞外层完全展开作腹膜前修补术治疗腹股沟疝203例,分析术后疼痛情况、近期并发症及远期慢性疼痛、复发、睾丸萎缩的发生情况,评价其效果。结果 203例全部在局麻下完成手术,手术时间15～65 min,平均31.4 min。术中出血0～20 mL,平均3.5mL。术后疼痛情况：注射镇痛药1例,口服芬必得13例,未用任何镇痛药189例。术后恢复日常活动和工作时间3～18d,平均8.7 d。术后近期并发症仅有血肿2例。186例中随访率91.6%,术后随访8～25个月,平均13.1个月,无复发、腹股沟感觉异常、慢性疼痛、睾丸萎缩等并发症。结论局麻下网塞腹膜前修补术治疗腹股沟疝能进一步降低术后复发率,减少术后腹股沟区慢性疼痛和异物不适感,创伤小,恢复快,适应证广。

Preperitoneal prostheses with mesh-plug by local anesthesia in treating inguinal hernia

Objective To evaluate the clinical value of preperitoneal prostheses with mesh-plug by local anesthesia in treating the inguinal hernia.Methods 203 cases treated with preperitoneal prostheses with expanded plug outer layer by local anesthesia between March were retrospectively investigated.Postoperative pain,short-term complications,long-term chronic pain,recurrence and testicular atrophy were evaluated.Results All cases were successful performed by local anesthesia.The mean operation time was 31.4 minutes（15～65 minutes）.The mean bleeding volume was 3.5mL（0～20mL）.There were no urine retention and wound infection.The mean time of resumption of daily activities and work was 8.7 days（3～18 days）.There were no recurrence,chronic pain,inguinal paresthesia and testicular atrophy.Conclusion Preperitoneal prostheses with mesh-plug by local anesthesia treating inguinal hernia should be further explored and applied.