Genitsaris Michael, Goulimaris Ioannis, Sikas Nikolas
Interbalkan European Medical Center, Thessaloniki, Greece.
Am J Sports Med. 2004 Jul-Aug;32(5):1238-42. doi: 10.1177/0363546503262203. Epub 2004 May 18.
There has been increasing interest regarding the cause and treatment of groin pain in athletes. The most common finding is a deficiency of the posterior wall of the inguinal canal, often repaired with bilateral inguinal myorrhaphy.
Laparoscopic repair will offer a shorter convalescent period and better results as compared with open myorrhaphy.
Retrospective review of prospectively collected data.
Between October 1993 and October 2002, 131 athletes with groin pain unrelieved after 2 to 8 months of conservative management underwent bilateral laparoscopic repair with the transabdominal preperitoneal technique for hernias. In 123 (94%) patients, physical examination revealed a dilated external ring, unilateral or bilateral, of the inguinal canal, and in 8 patients (6%) it was normal.
During laparoscopy, a deficiency of the posterior inguinal wall was seen in all athletes. All patients left the hospital 24 hours after the procedure, discontinued oral analgesics within 72 hours of surgery, and were back to full sporting activities within 2 to 3 weeks. Four patients (3%) complained of thigh pain. After a mean follow-up of 5 years (range, 4 months to 10 years), there was 1 recurrence (0.76%).
Laparoscopic repair is an efficient method for the treatment of groin pain originating from a deficiency of the posterior inguinal wall, having fast recovery and excellent long-term results.
运动员腹股沟疼痛的病因及治疗越来越受到关注。最常见的发现是腹股沟管后壁缺损,常采用双侧腹股沟肌修补术进行修复。
与开放肌修补术相比,腹腔镜修补术的恢复期更短,效果更好。
对前瞻性收集的数据进行回顾性分析。
1993年10月至2002年10月,131例经2至8个月保守治疗后腹股沟疼痛仍未缓解的运动员,采用经腹腹膜前技术进行双侧腹腔镜疝修补术。123例(94%)患者体格检查发现腹股沟管外环单侧或双侧扩张,8例(6%)患者正常。
腹腔镜检查时,所有运动员均可见腹股沟后壁缺损。所有患者术后24小时出院,术后72小时内停用口服镇痛药,2至3周内恢复全面体育活动。4例(3%)患者主诉大腿疼痛。平均随访5年(范围4个月至10年),有1例复发(0.76%)。
腹腔镜修补术是治疗因腹股沟后壁缺损引起的腹股沟疼痛的有效方法,恢复快,长期效果好。