Ziprin Paul, Prabhudesai Shirish G, Abrahams Solomon, Chadwick Stephen J
Department of Biosurgery and Surgical Technology, Imperial College, London, London, UK.
J Laparoendosc Adv Surg Tech A. 2008 Oct;18(5):669-72. doi: 10.1089/lap.2007.0130.
Groin pain in athletes presents a diagnostic and therapeutic challenge, particularly in distinguishing between those that will respond to nonoperative management and those that require surgery. Repair of sportsman's hernia, using the Modified Bassini darn or tension-free Lictenstein mesh technique, have been well described. The aim of this study was to assess the role of laparoscopy in the management of these hernias.
Seventeen consecutive male patients (median age, 27 years), presenting with symptoms and signs of sportsman's hernia to a district general hospital were reviewed. Five patients presented with unilateral groin pain, whereas 12 had bilateral symptoms. All patients underwent a diagnostic laparoscopy, followed by transabdominal preperitoneal polypropelene mesh (15 x 10 cm) repair. All patients except 1 were discharged within 24 hours of surgery, and their rehabilitation was supervised by a single physiotherapist. All patients were assessed postoperatively by the authors and at a median follow-up of 23 weeks.
The laparoscopy confirmed posterior wall weakness in all patients with bilateral symptoms and in 4 of 5 patients with unilateral groin pain. Following repair, no surgical morbidity occurred and the median return to sporting activities was 42 days. All but 1 patient returned to the level of sport reached prior to injury, and mild pain was experienced in 5 groins, which did not interfere with either normal daily or sports activity.
The transabdominal preperitoneal laparoscopic approach is safe and feasible in the diagnosis and treatment of Sportsman's hernia, enabling a full return to sports activities.
运动员腹股沟疼痛带来了诊断和治疗方面的挑战，尤其是在区分哪些患者能通过非手术治疗缓解以及哪些患者需要手术治疗时。使用改良 Bassini 缝补法或无张力 Lichtenstein 补片技术修复运动员疝，已有详尽描述。本研究旨在评估腹腔镜检查在这些疝治疗中的作用。
对一家地区综合医院连续收治的 17 例男性患者（中位年龄 27 岁）进行了回顾，这些患者均有运动员疝的症状和体征。5 例患者表现为单侧腹股沟疼痛，12 例有双侧症状。所有患者均接受了诊断性腹腔镜检查，随后进行经腹腹膜前聚丙烯补片（15×10 cm）修补术。除 1 例患者外，所有患者均在术后 24 小时内出院，其康复由一名物理治疗师监督。所有患者术后均由作者进行评估，中位随访时间为 23 周。
腹腔镜检查证实，所有双侧症状患者及 5 例单侧腹股沟疼痛患者中的 4 例存在后壁薄弱。修补术后未发生手术相关并发症，恢复体育活动的中位时间为 42 天。除 1 例患者外，所有患者均恢复到受伤前的运动水平，5 个腹股沟区有轻微疼痛，但不影响日常或体育活动。
经腹腹膜前腹腔镜手术方法在运动员疝的诊断和治疗中安全可行，能使患者完全恢复体育活动。
