耻骨肌孔的空间分离解剖在腹腔镜全腹膜外疝修补术中的应用及意义

发布时间：2018-05-25 08:36

本文选题：耻骨肌孔 + 空间解剖　；参考：《中国临床解剖学杂志》2014年03期

【摘要】：目的探讨应用腹腔镜技术对耻骨肌孔的空间分离解剖在腹腔镜全腹膜外疝修补术(totally extraperitoneal TEP)中的意义。方法我院自2005年至2013年开展TEP手术272例,术中将腹膜外耻骨肌孔区域分为初始空间、耻骨空间、髂窝空间和髂血管空间4个空间,依次解剖分离4个空间,在空间内安全操作。结果术中寻求相应解剖标志分别界定4个空间,最终融合为一个大范围空间。所有病例均应用耻骨肌孔的空间分离解剖技术指导完成手术,手术时间48 min(28~60 min),术后住院时间5 d(3~8 d)。术后随访2~60个月,其中2例出现阴囊血肿经抽吸后治愈,无疝复发病例,无切口及补片感染,无慢性疼痛、睾丸萎缩、射精痛等并发症发生,无疝复发。结论耻骨肌孔的空间分离解剖技术可以缩短TEP手术的学习曲线,加深对其复杂的耻骨肌孔及其后方解剖结构的学习和理解,提高手术效率和手术质量,减少手术并发症。
[Abstract]:Objective to investigate the significance of laparoscopic space separation anatomy of pubic foramen in laparoscopic total extraperitoneal herniorrhaphy. Methods from 2005 to 2013, 272 cases of TEP operation were performed in our hospital. During the operation, the external pubic foramen region was divided into four spaces: initial space, pubic space, iliac fossa space and iliac vascular space. Four spaces were dissected in turn and safely operated in space. Results the corresponding anatomical markers were found to define 4 spaces respectively and finally fused into a large space. All the patients were treated with the technique of space separation and anatomy of the foramen pubis. The operative time was 48 min(28~60, and the postoperative hospitalization time was 5 days, 3 days and 8 days. 2 cases of scrotal hematoma were cured after aspiration, no recurrence of hernia, no infection of incision and patch, no chronic pain, testicular atrophy, ejaculation and other complications, and no recurrence of hernia. Conclusion the spatial dissection of the foramen pubis can shorten the learning curve of TEP, deepen the study and understanding of the complex anatomy of the foramen pubis and its posterior anatomy, improve the efficiency and quality of the operation, and reduce the complications of the operation.
【作者单位】：南方医科大学微创外科解剖学研究所;南方医科大学附属小榄医院普外科;南方医科大学附属中山博爱医院普外科;
【分类号】：R656.2

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