腹腔镜经腹腹膜前疝修补术治疗嵌顿性腹股沟疝的应用价值

发布时间：2018-05-17 14:59

本文选题：疝 + 腹股沟　；参考：《中华疝和腹壁外科杂志(电子版)》2016年06期

【摘要】：目的探讨经腹腹膜前疝修补术(TAPP)治疗腹股沟嵌顿疝的安全性及优势。方法回顾性分析2012年3月至2015年3月,十堰市人民医院25例手术治疗腹股沟嵌顿疝患者的临床资料,全身麻醉后先在腹腔镜下还纳疝内容物,如肠管未坏死,则行TAPP术,术中置入10 cm×15 cm(网孔直径10 mm)的聚丙烯网片,覆盖整个耻骨肌孔。如肠管坏死,则根据情况行坏死小肠切除或结肠造口手术。结果 22例患者成功施行TAPP手术,未中转开腹,术后无补片感染及严重并发症发生。术中还纳、检查嵌顿肠管较便利,2例合并小肠坏死,于腹腔镜下完成肠切除手术,1例合并结肠坏死,于腹腔镜下行结肠造口术;所有合并肠坏死病例仅在腹腔镜下封闭疝环口,不再行TAPP手术。术后随访1~4年,未见复发。结论 TAPP治疗腹股沟嵌顿疝探查便利、操作方便、安全可行,疗效可靠、优势明显。
[Abstract]:Objective to investigate the safety and advantages of transabdominal anterior peritoneal hernia repair (TAPP) in the treatment of inguinal incarcerated hernia. Methods from March 2012 to March 2015, the clinical data of 25 patients with inguinal incarcerated hernia treated by operation in Shiyan people's Hospital were retrospectively analyzed. After general anesthesia, the contents of the hernia were returned under laparoscope, if the intestinal duct was not necrotic, TAPP was performed. A 10 cm 脳 15 cm (mesh diameter 10 mm) polypropylene mesh was inserted to cover the entire pubic foramen. If the bowel is necrotic, the case is necrotizing small intestine resection or colostomy. Results TAPP was successfully performed in 22 patients. No postoperative infection and severe complications occurred. There were 2 cases with intestinal necrosis, 1 case with colonic necrosis and 1 case with colonic necrosis. All cases with intestinal necrosis were only closed the herniation ring under laparoscope. No longer TAPP operation. Follow-up for 1 ~ 4 years showed no recurrence. Conclusion TAPP is convenient, safe and feasible in the treatment of inguinal incarcerated hernia.
【作者单位】：湖北省十堰市人民医院胃肠外科;
【分类号】：R656.21

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