摘要
目的通过对腹股沟区膜解剖的了解,辨认开放腹膜前入路手术的正确层面,减少术后复发率和并发症。方法对2006年1月至2018年3月东莞茶山医院450例原发性腹股沟疝患者进行术中观察、组织学分析和术后长期随访。结果腹股沟管有两个内环(中间环和内环)。进入Bogros间隙的"门户"是腹膜和腹膜前筋膜深层之间,而进入Retzius间隙的层面则是腹横筋膜和腹膜前筋膜浅层之间,这两个不连续的膜层面通过切开腹壁下血管处间隙韧带而贯通为一体的腹膜前间隙。术后随访平均53个月,慢性疼痛发生率和复发率均低于1%。结论熟悉腹股沟区膜结构的解剖有助于提高开放腹膜前疝修补术的安全性和可靠性,减少手术并发症和复发率。
Objective By understanding the anatomy of the inguinal membrane,the correct level of open anterior peritoneal approach can be identified to reduce the postoperative recurrence rate and complications.Methods From January 2006 to March 2018,450 patients with primary inguinal hernia in Dongguan Chashan Hospital were enrolled for intraoperative observation,histological analysis and long-term follow-up.Results The inguinal canal has two internal rings(the middle ring and the inner ring).The"portal"into the Bogros space is between the peritoneum and the deep layer of the preperitoneal fascia,while the layer into the Retzius space is between the transverse abdominal fascia and the superficial layer of the preperitoneal fascia.These two discontinuous membrane layers are connected in the preperitoneal space by cutting the interstitial ligament of the inferior epigastric vessels.The average follow-up time was 53 months.The incidence of chronic pain and the recurrence rate were less than 1%.Conclusion Understanding the anatomy of the inguinal membrane structure is helpful to improve the safety and reliability of open preperitoneal hernia repair and reduce the surgical complications and recurrence rate.
作者
周学鲁
黄海
骆剑华
郑富强
王友华
张焕彬
梁绍诚
Xuelu Zhou;Hai Huang;Jianhua Luo;Fuqiang Zheng;Youhua Wang;Huanbin Zhang;Shaocheng Liang(Department of Surgery,Chashan Hospital to Guangdong Medical University,Dongguan 523378,China)
出处
《中华疝和腹壁外科杂志（电子版）》
2022年第5期516-520,共5页
Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition)
关键词
疝
腹股沟
腹横筋膜
筋膜
疝修补术
Hernia
inguinal
Transverse fascia
Fascia
Herniorrhaphy
作者简介
通信作者:周学鲁,Email:zhouxuelulu@sina.com
