完全腹膜外腹腔镜疝修补术治疗老年腹股沟疝临床研究

目的：探讨腹腔镜完全腹膜外疝修补的方法在老年人腹股沟疝治疗中的作用。方法：回顾性分析2007年6月～2009年12月于我院接受完全腹膜外腹腔镜疝修补术（totally extraperitoneal prosthesis，TEP）治疗的老年腹股沟疝患者34例．与同期行常规开放疝修补术的32例老年腹股沟疝患者在手术时间、住院天数、并发症以及复发率上进行对比。结果：TEP组手术时间平均（58．0±12．6）min，开放组平均（72．0±22．6）min；术后住院时间TEP组平均（3．7±1．1）d，开放组平均（5．2±2．1）d；TEP组术中撕裂腹膜1例，未中转其他术式，术后发生急性尿潴留2例，无切口感染、阴囊积液或血肿及腹股沟区慢性疼痛等其他并发症发生。开放组术后急性尿潴留6例，3例发生慢性疼痛。随访时间3～28个月．两组均无复发病例。结论：完全腹膜外腹腔镜疝修补术对于老年腹股沟疝患者是可行、安全、有效的术式，且具有创伤小、恢复快、并发症少．复发率低等优点。

Laparoscopic repair of elderly patients with inguinal hernia by totally extraperitoneal prosthesis

Objective： To explore the clinical effects of laparoscopic repair in elderly patients with inguinal hernia by totally extraperitoneal prosthesis （TEP）. Methods： A retrospective method was used to compare 34 groin hernias in elderly patients who received TEP to 32 same patients who received open tension-free hemiorrhaghy （OTFH） from June 2007 to December 2009 in our hospital. Results： TEP group （34 cases） were underwent the completed laparoscopic operations and the mean operative time was （58.0±12.6） min, the OTFH group was （72.0±22.6） min; the duration of hospitalization in TEP group was （3.7±1.1） day and （5.2±2.1） day in OTFH group. In TEP group, 1 case had laceration of peritoneum during operation but turn to no other prosthesis; 2 cases occurred acute urinary retensions, no incision infectio,no scrotum hydrocele or scrotal hematom and no chronic pain in inguinal area or other complications were observed. OTFH group occurred 6 acute urinary retensions and 2 cases had chronic pain in inguinal area. No recurrence was found during a follow-up period of 3 to 28months in both two groups. Conclusion： TEP is a feasible, safe and efficient choice for elderly inguinal hernia patients, with the advantages of little trauma, faster postoperative recovery, less complications, lower recurrence rate, and so on.