腹腔镜下捆绑式锥形补片修补腹股沟疝的临床研究

目的探讨腹腔镜下采用捆绑式锥形补片修补腹股沟疝的方法及临床疗效。方法 2003年1月-2009年12月收治成人腹股沟疝1215例1363侧。男1132例1268侧,女83例95侧;年龄18～89岁,中位年龄58岁。原发疝1187例1329侧,复发疝28例34侧。病程1～9d,平均3.8d。腹股沟斜疝728例786侧,直疝416例499侧;股疝43例45侧;特殊类型疝28例33侧。根据疝分型标准,Ⅰ型31例38侧,Ⅱ型683例754侧,Ⅲ型403例452侧,Ⅳ型98例119侧。采用捆绑式锥形补片植入内环口,3点固定于疝环前壁肌肉、筋膜处;通过疝环口腹膜荷包缝合包埋补片,修补腹股沟疝。结果患者均顺利完成手术;手术时间18～32min,平均22min。术后出现腹股沟区牵拉性疼痛19例21侧,急性尿潴留8例,疝囊远端积液2例2侧,均经对症处理后治愈。术后切口均Ⅰ期愈合,无发热、感染和血肿发生。术后1095例1182侧获随访,随访时间1～7年,中位时间3年9个月。术后1～3年5例因内科疾病死亡。3例直疝复发,经再次腹腔镜手术治愈;其余患者无复发。存活患者均未发生肠粘连及肠梗阻。结论腹腔镜下捆绑式锥形补片修补腹股沟疝具有创伤小、手术操作简便、术后恢复快、并发症少及复发率低等优点。

Clinical research of laparoscopic bundled fastigiated mesh in repairing inguinal hernia

Objective To explore the method and effectiveness of laparoscopic bundled fastigiated mesh in repairing inguinal hernia.Methods Between January 2003 and December 2009,1 215 patients(1 363 sides) with inguinal hernia were treated.There were 1 132 males(1 268 sides) and 83 females(95 sides),aged from 18 to 89 years(median,58 years).The cases included 1 187 cases(1 329 sides) of primary hernia and 28 cases(34 sides) of recurrent hernia.There were indirect inguinal hernia in 728 cases(786 sides),direct inguinal...