CAJ | 학술논문

目的总结成人腹股沟疝腹腔镜修补术的经验,分析常见的手术并发症和术后复发原因.方法回顾性分析2007年3月至2010年9月行腹腔镜腹股沟疝修补术512例患者的临床资料,单侧腹股沟疝437例(斜疝281例、直疝86例、股疝15例、复合疝16例,复发疝39例),双侧腹股沟疝75例(含复发疝3例),其中包括急性腹股沟嵌顿疝41例.术后平均随访时间(29±12)个月.结果 512例中,507例患者成功行腹腔镜修补,完成经腹腹膜前补片植入术( transabdominalpreperitoneal,TAPP)238例(292侧),完全腹膜外补片植入术(totally extraperitoneal,TEP) 269例(290侧);5例中转开放手术.平均手术时间TAPP(69±19)min、TEP (58±15) min;术后平均住院时间(5.0±1.5)d;术后2周和4周恢复非限制活动人数分别为95.7％( 485/507)、99.0％(502/507);术后并发症依次为血清肿9.7％ (49/507)、暂时性神经感觉异常4.1％ (21/507)、术后慢性疼痛0.8％(4/507).术后复发率0.6％ (3/507).结论腹腔镜腹股沟疝修补术具有创伤小,恢复快,复发率低等优点.
목적 총결성인복고구산복강경수보술적경험,분석상견적수술병발증화술후복발원인.방법 회고성분석2007년3월지2010년9월행복강경복고구산수보술512례환자적림상자료,단측복고구산437례(사산281례、직산86례、고산15례、복합산16례,복발산39례),쌍측복고구산75례(함복발산3례),기중포괄급성복고구감돈산41례.술후평균수방시간(29±12)개월.결과 512례중,507례환자성공행복강경수보,완성경복복막전보편식입술( transabdominalpreperitoneal,TAPP)238례(292측),완전복막외보편식입술(totally extraperitoneal,TEP) 269례(290측);5례중전개방수술.평균수술시간TAPP(69±19)min、TEP (58±15) min;술후평균주원시간(5.0±1.5)d;술후2주화4주회복비한제활동인수분별위95.7％( 485/507)、99.0％(502/507);술후병발증의차위혈청종9.7％ (49/507)、잠시성신경감각이상4.1％ (21/507)、술후만성동통0.8％(4/507).술후복발솔0.6％ (3/507).결론 복강경복고구산수보술구유창상소,회복쾌,복발솔저등우점.
Objective To summarize the experiences in laparoscopic inguinal hernia repairing for adult patients. Methods Clinical data of 512 hernia cases admitted in our center from March 2007 to Sep 2010 were retrospectively analyzed.There were 437 cases of single-sided hernia,including 281 indirect inguinal hernia,86 direct inguinal hernia,15 femoral hernia,16 combined inguinal hernia and 39 recurrent hernia.There were also 75 cases of double-sided inguinal hernia,including 3 recurrent hernia.There were 41 acute incarcerated hernia cases.The average postoperative follow up time was(29 ± 12) months. Results 507 cases underwent successful laparoscopic repair,and 5 cases were converted to open procedure.There were 238 TAPP and 269 TEP in laparoscopic operations.The average operative time for TAPP was (69 ±19) min,and (58 ±15) min for TEP.The average length of postoperative stay was (5.0 ± 1.5) days.The percentage of resuming normal activity after 2 weeks and 4 weeks were 95.7％ (485/507) and 99.0％(502/507).The most common postoperative complications were seroma (9.7％,49/507),transient paresthesia (4.1％,21/507) and chronic pain (0.8％,4/507).The recurrence rate was 0.6％ (3/507).Conclusions Laparoscopic repair of inguinal hernia has the advantage of less trauma,faster recovery,and lower recurrence rate.