腹腔镜双侧腹股沟疝修补术的临床应用研究

发布时间：2018-03-26 09:30

本文选题：腹腔镜　切入点：双侧腹股沟疝　出处：《苏州大学》2015年硕士论文

【摘要】：目的评价腹腔镜双侧腹股沟疝修补术(TEP和TAPP)的临床疗效,分析研究术后并发症及疝复发因素,总结临床应用经验。资料和方法回顾性分析2013年6月至2014年12月苏州大学附属第二医院普外科行腹腔镜双侧腹股沟疝修补术的76例临床资料,其中全腹膜外修补术(TEP)50例,经腹腹膜前修补术(TAPP)26例。所有病人门诊和电话随访,随访时间6~24个月,中位时间15个月。结果所有手术均顺利完成,TEP组和TAPP组手术时间分别为84.40±29.20min和125.10±32.30min,术后住院时间分别为3.04±1.58d和3.12±0.77d,无病人术后应用止痛药物,术后第1天VAS分别为1.38±0.75分和1.61±0.72分,TEP中复发1例(1侧)。术后总的并发症8例,其中阴囊血肿1例(1侧),腹股沟区血清肿3例(4侧),暂时性神经感觉异常2例(2侧),尿潴留2例,无血管或者内脏损伤病例,切口均一期愈合,无缺血性睾丸炎、补片感染、肠梗阻、戳孔疝及慢性疼痛病例发生。结论腹腔镜双侧腹股沟疝修补术(TEP和TAPP)均安全有效,合理选择病人及手术方式,规范化的操作可以取得良好的临床效果和最佳的卫生经济学效益。
[Abstract]:Objective to evaluate the clinical efficacy of laparoscopic bilateral inguinal hernioplasty (TEP and TAPP) and to analyze the postoperative complications and hernia recurrence factors. Methods from June 2013 to December 2014, 76 cases of laparoscopic bilateral inguinal hernia repair were retrospectively analyzed in the second affiliated Hospital of Suzhou University, including 50 cases of total extraperitoneal herniorrhaphy. Twenty-six patients with TAPPV were treated with transabdominal preperitoneal repair. All patients were followed up by telephone and outpatient service for 624 months. Results the mean time of operation was 84.40 卤29.20min and 125.10 卤32.30min in all patients, and the hospital stay was 3.04 卤1.58d and 3.12 卤0.77d, respectively. No patients were treated with painkillers after operation. On the first day after operation, VAS were 1.38 卤0.75 and 1.61 卤0.72, respectively. The total postoperative complications included 1 case of scrotal hematoma (1 case), 1 side of scrotal hematoma (1 case), 3 cases of inguinal area seroedema (4 sides), 2 cases of temporary neurosensory abnormality (2 cases) and 2 cases of urinary retention. In the cases of no vascular or visceral injury, the incisions healed at the first stage, and there were no ischemic orchitis, patch infection, intestinal obstruction, hernia and chronic pain. Conclusion Laparoscopic bilateral inguinal hernioplasty is safe and effective. Reasonable selection of patients and operation methods, standardized operation can achieve good clinical results and the best economic benefits of health.
【学位授予单位】：苏州大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R656.21

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