摘要
目的:探讨腹腔镜完全腹膜外疝修补术(TEP)治疗Ⅲ型阴囊疝术中疝囊处理方式对术后阴囊积液的影响及处理方法。方法:回顾分析2015年6月至2017年5月收治的278例Ⅲ型阴囊疝患者的临床资料,按疝囊处理方式分为疝囊横断组(n=165)与疝囊剥离组(n=113),对比两组术后阴囊积液发生率。结果:278例均成功完成TEP,47例患者术后出现阴囊积液,其中横断组出现阴囊积液18例,发生率为10.9%;剥离组29例,发生率为25.7%;横断组阴囊积液发生率低于剥离组,差异有统计学意义(P<0.05)。32例积液深度<2 cm,经硫酸镁湿敷后积液自行吸收29例,硫酸镁湿敷联合穿刺抽液治愈3例; 15例积液深度≥2 cm,12例穿刺抽液后治愈,3例穿刺抽液后行阴囊积液切开引流治愈。术后随访2～24个月,无阴囊积液复发及斜疝复发病例。结论:术中处理Ⅲ型阴囊疝,横断结扎疝囊较完全剥离疝囊术后发生阴囊积液的几率降低,是较为安全的。术后发生阴囊积液后,予以湿敷及穿刺抽液治疗,效果显著,且安全、有效。
Objective:To investigate the influence of methods dealing with typeⅢscrotal hernia sac on scrotal hydrops after laparoscopic totally extraperitoneal(TEP)hernia repair and the treatment of scrotal hydrops.Methods:Clinical data of 278 patients with typeⅢscrotal hernia who underwent TEP were retrospectively analyzed from Jun.2015 to May 2017.All the patients were divided into the transected sac group(n=165)and the stripped sac group(n=113)by the methods dealing with hernia sac,in order to compare the occurrence rate of scrotal hydrops after operations.Results:All 278 patients underwent TEP successfully,47 patients suffered from scrotal hydrops after operations.There were 18 cases in the transected sac group,and the occurrence rate was 10.9%.While 29 cases were in the stripped sac group,and the occurrence rate was 25.7%.The occurrence rate of the transected sac group was lower than that of the stripped sac group(P<0.05).In the 47 cases,the depth of hydrops in 32 patients was less than 2 cm,and the scrotal hydrops of 29 patients were self-absorbed after wet application with magnesium sulphate,3 patients accepted puncture and aspiration after wet application.When it came to depth of hydrops in the other 15 patients,it was more than or equal to 2 cm.Moreover,12 patients were cured after puncture and aspiration,while 3 patients were cured after incision and drainage of scrotal hydrops under local anesthesia.The patients were followed up from 2 to 24 months,and there was no scrotal hydrops or hernia recurrence.Conclusions:Transected sac significantly reduces the incidence of scrotal hydrops when compared with stripping sac,and is safe in the treatment of typeⅢscrotal hernia.The wet application,puncture and drainage is safe and efficient in the treatment of scrotal hydrops after operation.
作者
王守光
李海风
刘忠诚
尹鹏
滕世岗
WANG Shou-guang;LI Hai-feng;LIU Zhong-cheng(Department of Gastrointestinal Surgery,Jiaozhou Central Hospital of Qingdao,Qingdao Laparoscopic Surgery Center,Qingdao 266300,China)
出处
《腹腔镜外科杂志》
2018年第10期753-756,共4页
Journal of Laparoscopic Surgery
关键词
Ⅲ型阴囊疝
完全腹膜外
疝修补术
腹腔镜检查
阴囊积液
TypeⅢscrotal hernia
Totally extraperitoneal
Herniorrhaphy
Laparoscopy
Scrotal hydrops
作者简介
王守光(1979—)男,山东省青岛市胶州中心医院胃肠外科主治医师,主要从事腹腔镜胃肠肿瘤及疝治疗方面的研究;通讯作者:刘忠诚,E-mail:lzcjzh@163.com。
