CAJ | 학술논문

目的：根据腹股沟区解剖特点，探讨腹腔镜下不钉合及双网片交叠的完全腹膜外疝修补术（TEP）的技术要点及安全性、有效性。方法回顾性分析我科2010年1月至2012年12月行腹腔镜下完全腹膜外疝修补术共248例的临床资料，均补片免钉合固定行双网片交叠，术后进行随访。其中，腹股沟斜疝200例，腹股沟直疝48例；单侧疝210例双侧疝38例。结果全部病例均成功施行TEP，平均手术时间30~102 min，单侧平均时间63 min，双侧98 min。并发症主要为阴囊血清肿28例，术后疼痛9例。住院时间为5~11 d，平均住院6 d。随访时间为6~30个月，术后均无复发。结论免钉合及双网交叠的 TEP 术式安全可靠且操作简单，具有术后疼痛少、复发率低、恢复快、腹壁切口美观的优点应值得推广。
목적：근거복고구구해부특점，탐토복강경하불정합급쌍망편교첩적완전복막외산수보술（TEP）적기술요점급안전성、유효성。방법회고성분석아과2010년1월지2012년12월행복강경하완전복막외산수보술공248례적림상자료，균보편면정합고정행쌍망편교첩，술후진행수방。기중，복고구사산200례，복고구직산48례；단측산210례쌍측산38례。결과전부병례균성공시행TEP，평균수술시간30~102 min，단측평균시간63 min，쌍측98 min。병발증주요위음낭혈청종28례，술후동통9례。주원시간위5~11 d，평균주원6 d。수방시간위6~30개월，술후균무복발。결론면정합급쌍망교첩적 TEP 술식안전가고차조작간단，구유술후동통소、복발솔저、회복쾌、복벽절구미관적우점응치득추엄。
Objective To investigate the anatomical characteristics of the inguinal region and the clinical effect without laparoscopic stapling and dual mesh overlap totally extraperitoneal laparoscopic mesh repair of hernia (TEP). Methods From January 2010 to December 2012, 248 patients was took without laparoscopic stapling and dual mesh overlap totally extraperitoneal laparoscopic mesh repair of hernia, 200 patients were inguinal hernia, 48 patients were inguinal hernia, 210 patients were unilateral and 38 patients were bilateral hernia. Postoperative all patents were follow-up and analyzed the clinical data retrospectively. Results All patients were successfully implemented TEP, the average operation time was 30min to 102min, the average time of unilateral was 63min, average time of bilateral was 98min. The complications consequences of 28 patients had scrotum seroma, 9 patients had postoperative pain. The hospital stay was 5 to 11 day; the average hospital was 6 day. Follow-up time was 6 to 30 months, no recurrence after surgery. Conclusions Without laparoscopic stapling and dual mesh overlap totally extraperitoneal laparoscopic mesh repair of hernia(TEP) was safe, reliable and have advantages such as less postoperative pain, the lower recurrence rate, fast recovery, aesthetic advantages abdominal incision .TEP can achieve good clinical result, should be widely applied.