腹膜前间隙无张力疝修补术在基层医院中的应用体会

目的总结腹膜前间隙无张力疝修补术在基层医院应用的经验和体会。 方法回顾分析2014年1月至2017年12月，贵州航天医院开展腹膜前间隙无张力疝修补手术治疗腹股沟疝385例患者的临床资料。 结果本组患者手术均顺利完成，手术时间46～68 min，平均（51.8±19.7）min。术后住院时间2～9 d，平均（3.7±1.6）d。术中出血量少，无精索及输精管损伤。术后出现并发症状28例，其中阴囊血肿1例，及时行负压引流治愈，发生浅部感染8例，尿潴留13例，阴囊肿胀6例，术后45 d阴囊肿胀消退，无触痛压痛等。术后12例诉患则腹股沟区疼痛及异物感，随时间而消失。全组随访1～35个月，无一例复发。 结论腹膜前间隙无张力疝修补术治疗腹股沟疝，具有安全有效，术后并发症少，恢复快，学习曲线短，适宜在基层医院开展。

Application of tension-free hernioplasty in anterior peritoneal space in primary hospital

ObjectiveTo summarize the experience in the application of tension-free hernioplasty in anterior peritoneal space in primary hospitals. MethodsA total of 385 cases with open preperitoneal tension-free hernia repair from Guizhou Aerospace Hospital were retrospectively analyzed form January 2014 to December 2017. ResultsThe operations were successful with a mean operation time of 46 to 68 minutes (51.8±19.7) minutes. The mean hospital stay was 2 to 9 days (3.7±1.6) days. There was less intraoperative bleeding, no spermatic cord and vas deferens injury. Postoperative complications occurred in 28 cases, including 1 case of scrotal hematoma, 8 cases of superficial infection, 13 cases of urinary retention, and 6 cases of scrotal swelling. 12 patients complained of inguinal pain and foreign body sensation, which disappeared with time. All patients were followed up for 1 to 35 months, none of them recurred. ConclusionTension-free herniorrhaphy in anterior peritoneal space for inguinal hernia is safe and effective, with less postoperative complications, quick recovery and short learning curve.