局部麻醉下腹膜前间隙无张力疝修补160例

目的：总结局部麻醉下腹膜前间隙无张力疝修补术的临床应用价值。方法回顾性分析2011年10月至2014年3月，同济大学医学院附属东方医院在局部麻醉下行开放式腹膜前间隙无张力疝修补术的腹股沟疝患者160例。结果本组患者手术过程顺利，手术时间30-65 min，平均（50±3）min；术后2-6 h下床活动；住院时间1-3 d。术后出现尿潴留12例，阴囊水肿9例，切口疼痛8例，经物理治疗后疼痛缓解。随访1-12个月，复发5例，经二次手术治愈。结论局部麻醉下腹膜前间隙无张力疝修补术是安全可行的，麻醉效果满意，并发症少，复发率低，精准的手术操作是腹股沟疝修补术成功的关键。

Preperitoneal tension-free hernia repair under local anesthesia

Objective To summarize the value of local anesthesia for tension-free inguinal hernia repair.Methods From October 201 1 to March 201 4,a retrospective analysis was performed to 1 60 cases of inguinal hernia who received preperitoneal tension-free hernia repair under local anesthesia in Shanghai Dongfang Hospital.Results The operating time for these patients was 35 to 60 minutes （mean of 50 ± 3 minutes）;patients return to physical activity in 2 to 6 hours after operations;the length of stay was 1 to 3 days.Postoperative urinary retention occurred in 1 2 cases,scrotal seroma in 9 cases;8 patients found incisional pain which improved by physical therapy.With a follow-up of 1 to 1 2 months,5 patients had recurrences,and reoperation were performed to them.Conclusion Preperitoneal tension-free hernia repair under local anesthesia is a safe and effective procedure,has satisfactory anesthesia effect,less complications and low recurrence rate.However,accurate operation is the key to a successful inguinal herniorrhaphy.