摘要
目的探究大斜疝腹腔镜经腹腹膜前腹股沟疝修补手术(TAPP)中,内环缺损缝合关闭的临床效果。方法纳入2022年2—10月,在皖南医学院第一附属医院胃肠外科接受TAPP术治疗的腹股沟大斜疝(欧洲疝学会分类L3型及以上者或阴囊疝)患者38例(46侧),进行回顾性研究。术中在植入补片展开前缝合疝环缺损(内环口),记录围手术期资料,观察术后并发症(术后重度疼痛、肠梗阻、切口相关并发症、补片感染、血肿、血清肿、持续性难治性疼痛、复发)发生情况。结果38例(46侧)手术均由同组医生完成,术中发现疝环缺损平均(3.5±0.5)cm。单侧手术时间(腹膜切开至腹膜缝合完毕)平均(58.3±11.9)min,关闭内环时间平均(8.7±3.2)min,术中出血量<2 ml。术后第1天静息状态疼痛视觉模拟评分平均2.5分。术后住院时间平均22 h。术后早期无重度疼痛、肠梗阻、切口相关并发症、补片感染或血肿发生。3侧(6.5%)疝于术后第7天发生血清肿,平均体积40.5 ml,均为轻度血清肿,在2个月内自行消退。随访2~10个月,平均5.4个月,无持续性难治性疼痛发生,无疝复发。结论在治疗腹股沟大斜疝的TAPP术中,应用内环缺损关闭方法可显著减少术后血清肿的形成和相关并发症。
Objective To explore the clinical effect of suture closure of the inner ring defect in laparoscopic transabdominal preperitoneal(TAPP)large indirect inguinal hernia repair.Methods From February 2022 to October 2022,38 patients(46 sides)with large indirect inguinal hernia(European Hernia Society classification L3 or above or scrotal hernia)who underwent TAPP at the Department of Gastrointestinal Surgery,the First Affiliated Hospital of Wannan Medical College were enrolled in this retrospective study.During the operation,the hernia ring defect(internal ring opening)was sutured before the mesh was implanted.The perioperative data were recorded,and the occurrence of postoperative complications(severe postoperative pain,intestinal obstruction,incision related complications,mesh infection,hematoma,seroma,persistent refractory pain,and recurrence)was observed.Results All 38 cases(46 sides)were operated on by the same surgeon.The average defect of hernia ring was(3.5±0.5)cm.The mean operation time was(58.3±11.9)min,and the mean time to close the inner ring was(8.7±3.2)min.The intraoperative blood loss was minimal.The mean resting visual analogue scale(VAS)was 2.5 on the first postoperative day.The average postoperative hospital stay was 22 hours.No severe pain,intestinal obstruction,incision-related complications,mesh infection or hematoma occurred in the early postoperative period.Mild seroma occurred in 3 sides(6.5%)on the 7th day after operation,with an average volume of 40.5ml.All seromas resolved spontaneously within 2 months.The patients were followed up for 2 to 10 months,with an average of 5.4 months.No persistent refractory pain or hernia recurrence occurred.Conclusion In TAPP for large indirect inguinal hernia,the application of the inner ring defect closure method can significantly reduce the formation of postoperative seroma and related complications.
作者
王俊峰
查顺鹏
汪浩
李浩然
韩婷
程正武
王宇
黄敏
吴佩
王小明
Wang Junfeng;Cha Shunpeng;Wang Hao;Li Haoran;Han Ting;Cheng Zhengwu;Wang Yu;Huang Min;Wu Pei;Wang Xiaoming(Department of Gastrointestinal Surgery,the First Affiliated Hospital of Wannan Medical College,Wuhu,Anhui,241001,China)
出处
《中华疝和腹壁外科杂志（电子版）》
2023年第2期145-148,共4页
Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition)
基金
皖南医学院校重点项目科研基金(WK2022ZF06)
安徽省教育厅重点项目科研基金(2022AH051248)
关键词
斜疝
腹腔镜
疝修补术
血清肿
Indirect hernia
Laparoscope
Heniorrhaphy
Seroma
作者简介
通信作者:王小明,Email:wxm6901@aliyun.com
