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成人腹股沟疝。腹腔镜控制下的腹膜下假体植入术(320例患者共411侧疝进行了370次手术)

[Inguinal hernia in adults. Subperitoneal prosthesis under celioscopic control (370 operated sides in 320 patients with 411 hernias)].

作者信息

Leroy J, Fromont G

机构信息

Service de Chirurgie viscérale, Clinique AHNAC, Bully-les-Mines.

出版信息

Chirurgie. 1994;120(1):27-32.

PMID:7736841
Abstract

The authors present their technique of groin hernias repair by putting of a very tall (15 X 15 cm for unilateral hernias, or 30 X 15 cm for bilateral hernias). Polypropylene prosthesis in subperitoneal space by laparoscopic access. From may 1991 to june 1993, 320 patients were operated on 370 sides (50 bilateral hernias) with a total of 411 hernias. The first results are analysed: there was in particular no conversion and infection. Recurrences were studied only on the patients operated since at least one year: There were 1 recurrence (0.6%) on 163 sides operated in 141 patients with a mean average follow up of 17 months. There were 2 occlusions (on 370 sides operated), by incarcerated small bowel in the preperitoneal space after partial failed of the peritoneal suture. The first patient was reoperated on at the fifteenth postoperative day (chronic occlusion) by laparotomy. The second patient was reoperated on at the fifth postoperative day by laparoscopy which permit to reduce the small bowel in the abdominal cavity and closing the peritoneum with a new suture. It should be observed that 74 patients (23%) were operated on epidural anesthesia.

摘要

作者介绍了他们通过腹腔镜进入腹膜下间隙放置非常大的(单侧疝为15×15厘米,双侧疝为30×15厘米)聚丙烯假体来修复腹股沟疝的技术。从1991年5月至1993年6月,320例患者接受了手术,共370侧(50例双侧疝),总计411个疝。分析了初步结果:特别是没有中转开腹和感染情况。仅对至少随访一年的手术患者进行复发情况研究:141例患者的163侧手术中有1例复发(0.6%),平均随访17个月。在370侧手术中有2例发生梗阻,是由于腹膜缝合部分失败后腹膜前间隙内小肠嵌顿。第一例患者在术后第15天(慢性梗阻)通过剖腹手术再次手术。第二例患者在术后第5天通过腹腔镜再次手术,该手术使小肠回纳入腹腔并用新的缝合线关闭腹膜。应当注意的是,74例患者(23%)接受了硬膜外麻醉。

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