简化腹股沟区解剖理念在腔镜腹股沟疝修补术中的临床应用

目的 探讨简化腹股沟区解剖在腔镜腹股沟疝修补术中的临床疗效及安全性、可行性。方法 回顾分析2018年9月至2019年3月中山大学附属第六医院80例腹股沟疝患者的临床资料。其中男59例、女21例,年龄为18~80（53.8±21.5）岁,左侧21例、右侧48例、双侧11例。患者均行腔镜经腹腹膜外腹股沟疝修补术,观察手术时间、术中出血量、术后住院时间以及术后并发症情况。结果 80例患者均顺利完成手术,无一例中转开腹。单侧疝患者手术时间27.8~51.4（43.2±5.6）min、双侧疝患者手术时间55.6~103.3（73.8±10.4）min,术中出血量2~6（3.6±1.1）mL,住院时间2~5（3.1±1.8）d。术后有2例患者发生术后血清肿,2例患者出现术后第1天腹股沟区疼痛,予相应处理后可缓解。术后74例获随访,随访时间2018年9月1日~2019年12月31日,平均9个月。随访期间无一例患者复发。结论 简化的腹股沟区解剖简单易懂,可以有效缩短TAPP手术的学习曲线,有利于手术的规范化,适合推广应用。

Application of simplified anatomy of inguinal region in laparoscopic inguinal hernia repair

Objective To investigate the clinical efficacy, safety and feasibility of simplified inguinal area anatomy in endoscopic inguinal hernia repair. Methods The clinical data of 80 patients with inguinal hernia in the Sixth Affiliated Hospital of Sun Yat-sen University from September 2018 to March 2019 were retrospectively analyzed. There were 59 males and 21 females, aged from 18 to 80 （53.8±21.5） years old. There were 21 on the left side, 48 on the right side, and 11 on both sides. All patients underwent endoscopic transabdominal extraperitoneal inguinal hernia repair, and the operative time, intraoperative blood loss, postoperative hospital stay and postoperative complications were observed. Results All the 80 patients completed the operation successfully, and none of them was converted to open surgery. The operative time of unilateral hernia patients was 27.8~51.4 （43.2± 5.6） min, and that of bilateral hernia patients was 55.6~103.3 （73.8± 10.4） min, the intraoperative blood loss was 2~6 （3.6± 1.1） mL, and the hospital stay was 2~5 （3.1± 1.8） days. Postoperative seroma occurred in 2 patients, and groin pain occurred in 2 patients on the first day after operation, which could be relieved after corresponding treatment. Seventy-four patients were followed up from September 1, 2018 to December 31, 2019, for an average of 9 months. None of the patients recurred during the follow-up. Conclusion The simplified inguinal region anatomy is simple and easy to understand, can effectively shorten the learning curve of TAPP surgery, and it is conducive to the standardization of surgery, suitable for popularization and application.