腹腔镜诊治老年嵌顿性腹股沟疝62例临床分析

目的:探讨腹腔镜技术诊治老年嵌顿性腹股沟疝的应用价值。方法:回顾分析2017年1月至2019年2月收治的62例老年嵌顿性腹股沟疝患者的临床资料,包括一般资料、手术成功率、并发症发生率、死亡率、复发率。结果:62例患者中斜疝59例,直疝1例,股疝2例,患者均完成腹腔镜探查及疝内容物还纳,其中5例行肠切除加内环口成形术,55例行腹腔镜经腹膜前疝修补术,2例中转李金斯坦术。手术时间平均(76.4±18.9)min;平均住院(5.9±1.8)d;术后发生血清肿发生率2例(3.2%),无切口感染、慢性疼痛发生;死亡率1.6%(1/62)。术后随访4~24个月,随访率78.7%(48/61),无复发病例。结论:腹腔镜技术具有探查优势,诊治老年嵌顿性腹股沟疝安全、有效。

The clinical application of laparoscopy in diagnosis and treatment of elderly incarcerated inguinal hernia:a retrospective analysis of 62 patients

Objective:To evaluate the clinical application of laparoscopy in diagnosis and treatment of elderly incarcerated inguinal hernia.Methods:Between Jan.2017 and Feb.2019,62 elderly patients were enrolled in this study,they were diagnosed as incarcerated inguinal hernia and treated by laparoscopy.Their clinical data were retrospectively collected and analyzed,including general data,success rate,postoperative complications,mortality and recurrence rate.Results:Among the 62 patients,there were 59 cases of indirect hernia,1 direct hernia and 2 cases of femoral hernia,all of the operations were completed by laparoscopy.55 patients received laparoscopic transabdominal preperitoneal hernia repair,5 patients received partial enterectomy and internal hernia ring reformation,and the other 2 patients were transferred to Lichtenstein inguinal hernia repair.The average operation time was(76.4±18.9)min and the hospitalization time was(5.9±1.8)d.In terms of the postoperative complications,2 patients(3.2%) suffered from the hematoma,1 patient(1.6%) died after the operation,no incision infection or chronic pain occurred.The patients were followed up for 4 to 24 months after operation and 48 patients completed the follow-up,during which no recurrence occurred.Conclusions:Laparoscopic hernioplasty is an advantaged,safe and effective method for the exploration as well as the diagnosis and treatment of elderly incarcerated inguinal hernia.