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腹腔镜修复复发性腹股沟疝

Laparoscopic repair of recurrent groin hernias.

作者信息

Felix E L, Michas C, McKnight R L

机构信息

Center for Hernia Repair, Fresno, California.

出版信息

Surg Laparosc Endosc. 1994 Jun;4(3):200-4.

PMID:8044363
Abstract

Between November 1991 and May 1993, 54 recurrent groin hernias were laparoscopically repaired in 50 patients. Forty-eight were men and two were women. Forty-six recurrent hernias were unilateral and four bilateral. Twenty-five were direct, 19 indirect, 10 pantaloon, and two had a femoral component. In only 10 patients was the contralateral side normal. In 27 patients, the other side had been previously repaired, and in 13 they had a new contralateral hernia. A transabdominal preperitoneal technique was used to dissect and repair the entire floor in all patients. A single sheet of polypropylene mesh was used in the repair of the women patients, and a double-buttress technique with the first sheet slitted for the cord was used for the men. Patients were examined every 3 months for the first year and at 6-month intervals thereafter. Follow-up ranged from 1 to 18 months with a mean of 8 months. No patient was lost to follow-up, and no recurrence was observed. Patients returned to normal activity in an average of 1 week. Seroma, which resolved spontaneously, was the most common complication. The overall short-term results suggested that a laparoscopic mesh buttressed repair of recurrent groin hernias is technically feasible and can eliminate early rerecurrence of the hernia so commonly seen after repair of recurrent hernias.

摘要

1991年11月至1993年5月期间,对50例患者的54例复发性腹股沟疝进行了腹腔镜修补术。其中48例为男性,2例为女性。46例复发性疝为单侧,4例为双侧。25例为直疝,19例为斜疝,10例为马裤疝,2例伴有股疝成分。仅10例患者对侧正常。27例患者另一侧先前已修补,13例患者对侧出现新疝。所有患者均采用经腹腹膜前技术分离并修补整个盆底。女性患者修补时使用单张聚丙烯补片,男性患者采用双支撑技术,第一张补片为精索做切口。患者在第一年每3个月检查一次,此后每6个月检查一次。随访时间为1至18个月,平均8个月。无失访患者,未观察到复发。患者平均1周后恢复正常活动。最常见的并发症是血清肿,可自行消退。总体短期结果表明,腹腔镜补片支撑修补复发性腹股沟疝在技术上是可行的,并且可以消除复发性疝修补后常见的早期再复发。

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