CAJ | 학술논문

目的：探讨自制简易气囊分离技术在腹腔镜完全腹膜外修补术（TEP）中应用的可行性。方法回顾性分析2013年1～7月，河北医科大学第二医院在全身麻醉下，采用自制简易气囊分离技术建立腹膜前间隙行TEP手术42例（54侧），其中双侧腹股沟疝12例。腹股沟斜疝38侧，腹股沟直疝16侧。结果手术均获得成功，单侧手术时间（28±10）min，双侧为（49±15）min。术中出血（4．3±1．8）ml，均无腹膜破裂。术后出现阴囊气肿3例，下腹壁腹膜外积液2例，经穿刺抽吸后痊愈。术后住院时间（2．4±1．2）d，恢复日常活动时间（5．2±1．7）d。术后随访时间6～12个月，未见复发和腹股沟区慢性疼痛等并发症的发生。结论在TEP手术中，采用自制简易气囊分离技术建立腹膜前间隙是安全可行和经济实用的，有利于初学者掌握和基层医院推广。
목적：탐토자제간역기낭분리기술재복강경완전복막외수보술（TEP）중응용적가행성。방법회고성분석2013년1～7월，하북의과대학제이의원재전신마취하，채용자제간역기낭분리기술건립복막전간극행TEP수술42례（54측），기중쌍측복고구산12례。복고구사산38측，복고구직산16측。결과수술균획득성공，단측수술시간（28±10）min，쌍측위（49±15）min。술중출혈（4．3±1．8）ml，균무복막파렬。술후출현음낭기종3례，하복벽복막외적액2례，경천자추흡후전유。술후주원시간（2．4±1．2）d，회복일상활동시간（5．2±1．7）d。술후수방시간6～12개월，미견복발화복고구구만성동통등병발증적발생。결론재TEP수술중，채용자제간역기낭분리기술건립복막전간극시안전가행화경제실용적，유리우초학자장악화기층의원추엄。
Objective To explore the feasibility of self-made simple balloon dissector in laparoscopic totally extraperitoneal hernia repair.Methods A total of 42 patients(54 sides)received TEP with self-made simple balloon dissector for separating preperitoneal space under general anesthesia from January 201 3 to July 201 3,including 1 2 cases of bilateral inguinal hernia,38 sides of indirect inguinal hernia,and 1 6 sides of direct inguinal hernia.Results The operations were successful in all patients.The average operation time of single side was (28 ±1 0)minutes,and that of double side was (49 ±1 5)minutes. The mean of blood loss during operation was (4.3 ±1 .8)ml.No peritoneum laceration was found.But the postoperative scrotum pneumatosis was found in 3 cases,and the abdominal hydrocele in 2 cases that can be cured by repeated puncture and aspiration.The average postoperative hospital stay was (2.4 ±1 .2)days, and the mean duration to normal activities was (5.2 ±1 .7)days.No recurrence or chronic pain in operation area were found during the follow-ups of 6 to 1 2 months.Conclusions The technique of self-made simple balloon dissector for separating preperitoneal space is feasible,safe,effective and economical in TEP,which is easy to be handled.