采用脊髓麻醉的完全腹膜外腹腔镜腹膜前疝修补术。
Total extraperitoneal preperitoneal laparoscopic hernia repair using spinal anesthesia.
作者信息
Molinelli Bruce M, Tagliavia Alfonso, Bernstein David
机构信息
Department of Surgery, Greenwich Hospital, Yale New Haven Health System, Greenwich, Connecticut, USA.
出版信息
JSLS. 2006 Jul-Sep;10(3):341-4.
BACKGROUND
Laparoscopic herniorrhaphy is a well-debated approach to inguinal hernia repair. Multiple technical and outcome variables have been compared with those of traditional open inguinal hernia repairs. One of these variables is the choice of anesthesia. To date, no reports describe the use of spinal anesthesia for laparoscopic hernia repairs. We present herein a review of our experience with spinal anesthesia for the total extraperitoneal preperitoneal laparoscopic hernia repair (TEP).
METHODS
We prospectively reviewed 30 patients undergoing TEP while under spinal anesthesia. Methods of anesthesia, surgical procedure, operative and anesthesia delivery times, as well as outcomes were reviewed. Patients were followed up over a 2-year period. Short- and long-term results of the surgical procedure and anesthesia delivered were noted.
RESULTS
All patients underwent successful laparoscopic hernia repair while under spinal anesthesia without conversion to general anesthesia. Forty-four hernias were repaired in 30 patients. Short- and long-term follow-up (2 years) revealed no significant untoward affects from the spinal anesthesia in this series of patients. Aside from inguinodynia in 3 patients in the short-term, no other short-term or long-term untoward sequelae occurred.
CONCLUSIONS
Spinal anesthesia is a feasible, and in our experience, the preferable method of anesthesia for total extraperitoneal laparoscopic hernia repair.
背景
腹腔镜疝修补术是腹股沟疝修补术一种备受争议的方法。已将多种技术和结果变量与传统开放性腹股沟疝修补术的变量进行了比较。这些变量之一是麻醉方式的选择。迄今为止，尚无关于脊髓麻醉用于腹腔镜疝修补术的报道。在此，我们介绍我们在脊髓麻醉下行完全腹膜外腹腔镜疝修补术（TEP）的经验回顾。
方法
我们前瞻性地回顾了30例在脊髓麻醉下行TEP的患者。回顾了麻醉方法、手术过程、手术及麻醉实施时间以及结果。对患者进行了为期2年的随访。记录了手术和麻醉的短期及长期结果。
结果
所有患者在脊髓麻醉下均成功进行了腹腔镜疝修补术，未转为全身麻醉。30例患者共修补了44处疝。短期和长期随访（2年）显示，该系列患者中脊髓麻醉未产生明显不良影响。除3例患者短期内出现腹股沟疼痛外，未发生其他短期或长期不良后遗症。
结论
脊髓麻醉是可行的，且根据我们的经验，是完全腹膜外腹腔镜疝修补术首选的麻醉方法。
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