疝囊横断技术在老年人腹腔镜完全腹膜外疝修补术中的应用

目的:探讨疝囊横断技术在老年人腹腔镜完全腹膜外疝修补术(totally extraperitoneal prosthesis,TEP)中的安全性及有效性。方法:回顾分析2009年至2011年为25例60岁以上老年患者行腹腔镜TEP的临床资料,将其分为两组,13例术中采用疝囊横断技术(实验组),12例术中完全剥离疝囊(观察组)。结果:两组患者术后第2天疼痛分数、并发症发生率及住院时间差异无统计学意义(P>0.05),手术时间差异有统计学意义(P<0.01)。结论:老年人腹腔镜TEP术中采用疝囊横断技术安全有效,不增加术后并发症发生率及复发率,可缩短手术时间,减少术中损伤、出血、手术及麻醉相关并发症的发生。

The clinical application of transecting the hernia sac during laparoscopic totally extraperitoneal prosthesis for aged patients

Objective:To investigate the safety and efficacy of transection of the hernia sac during laparoscopic totally extraperitoneal prosthesis(TEP) for aged patients.Methods:The clinical data of 25 elderly patients who were older than 60 years old and underwent laparoscopic TEP from 2009 to 2011 were retrospectively analyzed.The patients were classified into two groups:the transected sac(TS) group with 13 cases and the completely reduced sac(RS) group with 12 cases.Results:No significant difference was found between the TS and RS groups in postoperative pain on the second day,hospital stay and postoperative complications,except for the mean operative time(P<0.01).Conclusions:Transection of the hernia sac is a safe and effective technique for TEP in cases with difficult hernia sac dissection especially for the old.It is demonstrated that transection of the hernia sac dose not increase significant postoperative complications and recurrence.It reduces the intraoperative injury and bleeding.Surgical and anesthetic complications are reduced for shorter operative time.