膜解剖理念在腹腔镜完全腹膜外疝修补术中的应用

目的探讨膜解剖理念在腹腔镜完全腹膜外疝修补术（TEP）中的应用。 方法回顾性分析2016年1月至2019年12月，南方医院和广州市红十字会医院腹股沟疝患者311例，按手术方式分标准TEP组（169例）和膜解剖TEP组（142例），比较2组患者术中腹壁下血管损伤、膀胱表面血管损伤、生殖血管损伤、输精管损伤、腹膜破损和术后疝复发情况。 结果与标准TEP组比较，膜解剖TEP组的腹壁下血管损伤少，膀胱表面血管损伤少，腹膜破损率低，差异均有统计学意义（P<0.05）；2组生殖血管损伤、输精管损伤和术后疝复发情况比较，差异无统计学意义（P>0.05）。 结论膜解剖理念在TEP中的应用，对减少术中血管损伤和腹膜破损有优势，值得临床推广。

Application of membrane anatomy TEP in treatment of inguinal hernia

ObjectiveTo explore the application of membrane anatomy TEP in the treatment of inguinal hernia. MethodsBetween January 2016 and December 2019, a retrospective study in Nanfang Hospital and Red Cross Hospital was conducted on 311 cases of primary inguinal hernia patients who were assigned into two groups, standard TEP group (n=169) and membrane anatomy TEP (n=142). Intraoperative data (inferior epigastric vessels injury, bladder surface vessels injury, reproductive blood vessels injury, vas deferens injury, peritoneum breakage), and long term postoperative data such as recurrence rate were compared. ResultsCompared with the standard TEP group, the membrane anatomy TEP group had less inferior epigastric vessels injury, less bladder surface vessels injury and less peritoneum breakage rate (P<0.05). There were no statistically significant differences between two groups about reproductive blood vessels injury, vas deferens injury and recurrence rate (P<0.05). ConclusionAs compared with standard TEP, membrane anatomy TEP has fewer vessels injury and peritoneum breakage. It is a better method for inguinal hernia patients.