腹腔镜下完全腹膜外疝修补术治疗成人腹股沟疝：单中心1021例报道

doi:10.3969/j.issn.1005-6483.2020.07.020

摘要/Abstract

摘要： 目的总结腹腔镜下完全腹膜外疝修补术（totally extraperitoneal prosthesis，TEP）治疗成人腹股沟疝的经验。
方法 2014年5月～2019年5月行TEP手术病人1021例，分析手术时间及血清肿发生率与一般临床资料之间的相互关系。
结果完成TEP手术1021例，无中转开放手术。平均手术时间（37.93±16.14）分钟，术中平均出血量（3.55±3.02）ml，术后引流量平均（75.44± 53.11）ml，术后平均住院时间（4.25±0.86）天，术后发生血清肿12例，并发睾丸疼痛3例，脐部切口感染2例，未见补片感染、疝复发、睾丸萎缩及慢性疼痛。双侧疝的手术时间长于单侧疝，差异有统计学意义（P<0.05）；斜疝的手术时间要长于直疝，差异有统计学意义（P<0.05）；阴囊疝的手术时间要长于非阴囊疝，差异有统计学意义（P<0.05）。阴囊疝术后的血清肿发生率要高于非阴囊疝，差异有统计学意义（P<0.05）。
结论阴囊疝是增加TEP手术难度的重要因素，是TEP术后血清肿发生的独立危险因素。

关键词: 腹腔镜, 完全腹膜外, 腹股沟疝

Abstract: Objective To investigate the diagnosis and treatment of adult inguinal hernia by totally extraperitoneal prosthesis（TEP）under laparoscopy.
MethodsA retrospective analysis was performed on 1021 cases of TEP in our hospital from May 2014 to May 2019，and the correlation between operation time，the incidence of seroma and general clinical data was compared and analyzed to summarize clinical experience.
ResultsIn this group，1021 patients underwent TEP，and no patients were transferred to open surgery.The average operative time（37.93±16.14）min，the average intraoperative blood loss（3.55±3.02）ml，the average postoperative drainage volume（75.44±53.11）ml，the average postoperative hospital stay（4.25±0.86）days.There were 12 cases of seroma，3 cases of testicular pain，2 cases of umbilical incision infection，and no patch infection，hernia recurrence，testicular atrophy or chronic pain.The operation time of bilateral hernia was longer than that of unilateral hernia，and the difference was statistically significant（P<0.05）.The operation time of indirect hernia was longer than that of direct hernia，and the difference was statistically significant（P<0.05）.The operation time of scrotal hernia was longer than that of non-scrotal hernia，and the difference was statistically significant（P<0.05）.The incidence of seroma after scrotal hernia was higher than that of non-scrotal hernia，and the difference was statistically significant（P<0.05）.
Conclusion Scrotal hernia is an important factor that increases the difficulty of TEP operation and is an independent risk factor for seroma after TEP operation.

Key words: laparoscopic, total extraperitoneal, inguinal Hernia

吕志强沈根海戴玮王刚高泉根. 腹腔镜下完全腹膜外疝修补术治疗成人腹股沟疝：单中心1021例报道[J]. 临床外科杂志, 2020, 28(7): 666-668.

LV Zhiqiang, SHEN Genhai, DAI Wei, et al.. Laparoscopic total extraperitoneal hernia repair for adult inguinal hernia：a report of 1021 cases in a single center[J]. JOURNAL OF CLINICAL SURGERY, 2020, 28(7): 666-668.

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