腹腔镜腹股沟直疝修补术中假性疝囊处理的临床研究

目的探讨腹股沟直疝经全腹膜外修补术中个体化手术方式固定假性疝囊的临床疗效。 方法选择2014年1月至2016年1月，湖北医药学院附属太和医院收治106例腹股沟直疝患者的临床资料，由随机数字表法随机分成固定组（53例）与常规组（53例）。术后随访2年，分别观察2组手术时间、术后第1和3天疼痛评分、术后住院时间、住院费用及术后并发症（血清肿、局部异物感、阴囊肿胀、伤口感染、腹股沟区慢性疼痛）发生率、术后2年疝复发率。 结果2组患者的手术时间、术后第1和3天疼痛评分和住院时间及住院费用比较，差异无统计学意义（P>0.05）。固定组血清肿及局部异物牵拉感的发生率较常规组显著减少，差异有统计学意义（P<0.05），而在阴囊肿胀、伤口感染、术后腹股沟区慢性疼痛并发症发生率方面比较，差异无统计学意义（P>0.05）。随访2年，2组均无疝复发。 结论腹腔镜腹股沟直疝修补术中采用固定直疝假性疝囊可有效减少术后血清肿及术区异物牵拉感，是一种安全、经济、有效的固定方法。

Clinical study on treatment of false hernia sac during laparoscopic direct inguinal hernia repair

ObjectiveTo evaluate the clinical effects of individuated surgical procedures for managing false hernia sac following laparoscopic direct inguinal hernia repair. MethodsFrom January 2014 to January 2016, 106 patients with a clinical diagnosis of direct inguinal hernia were enrolled. According to the random number table, the patients divided into the fixed treatment group (53 cases) and the routine treatment group (53 cases) randomly. Operation time, postoperative pain score on the 1st and 3th day, postoperative hospitalization time, hospitalization expenses, postoperative complications (seroma, discomfort and foreign body feeling, swelling of scrotum, wound infection, chronic groin pain) and hernia recurrence rate within 2 years were observed. ResultsThe fixed treatment group compared with the routine treatment group, the operative time, postoperative pain score on the 1st and 3rd day, postoperative hospitalization time, hospitalization expenses, postoperative complications (swelling of scrotum, wound infection, chronic groin pain) had no significantly different between the two groups (P>0.05). The incidence of postoperative seroma and discomfort and foreign body feeling in the fixed treatment group was significantly lower than in the routine treatment group (P<0.05). No hernia recurrence was found in all two groups. ConclusionsThe primary repair of direct inguinal hernia defects with individuated surgical procedures during laparoscopic direct inguinal hernia repair is safe, economical and efficient for prevention of postoperative seroma, and discomfort/foreign body feeling, which could be applied in the clinic.