腹腔镜下腹腔内网片植入术治疗成人腹股沟疝(546例中期随访结果)

目的总结腹腔镜下腹腔内网片植入术（intraperitoneal onlay polytetrafluoroethylene mesh repair，IPOM）治疗成人腹股沟疝的中期随访结果。方法回顾分析2002年6月～2004年12月两家医院以腹腔镜IPOM方法治疗的546例603侧腹股沟疝。以钉合枪固定补片，利用脐内侧韧带腹膜覆盖网片的内侧。结果除2例因疝缺损太大中转开放手术外，手术均获成功，无手术并发症。术后并发症5例，均为血清肿，理疗后吸收。手术时间25-40min，平均31min。住院时间36-72h。平均46h。随访18-48个月，平均28个月，6例复发（复发时间30-45个月，平均38．2月），复发率0．995％。结论腹腔镜下IPOM治疗成人腹股沟疝效果确切、创伤少、并发症少、术后恢复快，充分体现微创优点。

Laparoscopic intraperitoneal onlay mesh herniorrhaphy for adult inguinal hernia: A mid-term follow-up outcomes in 546 cases

Objective To evaluate mid-term clinical effects of laparoscopic intraperitoneal onlay mesh herniorrhaphy (IPOM) for adult inguinal hernia. Methods A retrospective analysis was made on 546 cases of inguinal hernia treated by IPOM (603 sides) between June 2002 to December 2004. We closed the hernia sac by the lift-insert method following with the implantation of the Prolene mesh with the help of a stapler. Results The operation was successfully completed in all the cases, except for 2 cases of conversions to open surgery because of difficulties in covering the defects. There were no intraoperative complications, and 5 cases of postoperative seroma which subsided after physical therapy. The operative time was 25~40 min (mean, 31 min), and the hospital stay was 36~72 h (mean, 46 h). Follow-up observations for 18~48 months (mean, 28 months) found 6 cases of recurrence, with the recurrence time at 30~45 months (mean,38.2 months). The racurrence rate was 0.995%. Conclusions Laparoscopic intraperitoneal onlay mesh herniorrhaphy a minimally invasive method with reliable outcomes, low recurrence rate, and rapid recovery.