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腹腔镜技术治疗腹膜透析患者腹股沟疝:15 例经验。

Laparoscopic Techniques in Treatment of Inguinal Hernia in Patients with Peritoneal Dialysis: Experiences from 15 Cases.

机构信息

Department of General Surgery and The First Affiliated Hospital of Shandong First Medical University (Shandong Provincial Qianfoshan Hospital), Jinan, China.

Postgraduate Department, Shandong First Medical University, Jinan, China.

出版信息

J Laparoendosc Adv Surg Tech A. 2023 Aug;33(8):738-742. doi: 10.1089/lap.2023.0088. Epub 2023 Apr 19.

Abstract

This study aimed to investigate the feasibility, efficacy, and safety of laparoscopic transabdominal preperitoneal (TAPP) repair in the treatment of inguinal hernia in patients on peritoneal dialysis, and the optimal timing for initiating postoperative peritoneal dialysis. We conducted a retrospective analysis of the clinical data pertaining to patients on peritoneal dialysis with inguinal hernias treated with TAPP repair in the First Affiliated Hospital of Shandong First Medical University from July 15, 2020 to December 15, 2022. Follow-up observations of the treatment effect were also analyzed. A total of 15 patients underwent TAPP repair with success. Contralateral occult hernias were found in 3 cases intraoperatively and were treated simultaneously. During the operation, it was found that the peritoneal dialysis tube was completely wrapped in the omentum majus in 1 case and incompletely wrapped in 5 cases and was separated smoothly under laparoscopy. For patients on peritoneal dialysis with inguinal hernia, TAPP repair has the advantages of less trauma, simultaneous treatment of contralateral occult hernias, adjustment and fixation of peritoneal dialysis tubes, lower incision complication rates, and lower recurrence rates, compared with open surgery. With the gradual resumption of peritoneal dialysis 7 days postoperatively, TAPP repair can be performed safely and effectively in this population group; thus it is a procedure worth promoting.

摘要

本研究旨在探讨腹腔镜经腹腹膜前修补术(TAPP)治疗腹膜透析患者腹股沟疝的可行性、疗效和安全性,以及术后开始腹膜透析的最佳时机。我们回顾性分析了 2020 年 7 月 15 日至 2022 年 12 月 15 日在山东第一医科大学第一附属医院接受 TAPP 修复治疗的腹膜透析患者的临床资料,并对治疗效果进行了随访观察。共有 15 例患者成功接受了 TAPP 修复。术中发现 3 例存在对侧隐匿疝,同时进行了治疗。术中发现 1 例腹膜透析管完全被大网膜包裹,5 例不完全包裹,均在腹腔镜下顺利分离。对于腹膜透析并发腹股沟疝的患者,TAPP 修复术与开放手术相比,具有创伤小、可同期治疗对侧隐匿疝、调整和固定腹膜透析管、切口并发症发生率低、复发率低等优点。术后 7 天逐渐恢复腹膜透析,TAPP 修复术在该人群中安全有效,值得推广。

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