• 西安交通大學(xué)醫(yī)學(xué)院第一附屬醫(yī)院普外科(西安 710061);

目的 評(píng)價(jià)3DMax補(bǔ)片在腹腔鏡下全腹膜外修補(bǔ)術(shù)(totally extraperitoneal,TEP)中修補(bǔ)腹股溝疝的價(jià)值。
方法 回顧性分析我院2009年2～6月期間腹腔鏡下應(yīng)用3DMax補(bǔ)片對(duì)18例腹股溝疝患者行TEP的臨床資料，分析其手術(shù)時(shí)間、住院時(shí)間、復(fù)發(fā)和并發(fā)癥發(fā)生情況。
結(jié)果 18 例患者中Ⅰ型疝3例，Ⅱ型疝4例，Ⅲ型疝9例，Ⅳ型疝2例； 斜疝11例，直疝6例，股疝1例。成功完成腹腔鏡下TEP 17例。1例因疝內(nèi)容物為末端回腸，與疝囊粘連并局部狹窄梗阻，中轉(zhuǎn)開放手術(shù)切除部分回腸。手術(shù)時(shí)間40～95 min，平均65.4 min。術(shù)后均未使用鎮(zhèn)痛劑，術(shù)后住院時(shí)間2～7 d，平均住院5.5 d。術(shù)后發(fā)生陰囊血清腫1例，經(jīng)穿刺排液后愈合良好。隨訪1～6個(gè)月，無復(fù)發(fā)病例。
結(jié)論 腹腔鏡下TEP具有創(chuàng)傷小、恢復(fù)快、復(fù)發(fā)率低等優(yōu)點(diǎn)，采用預(yù)先成型的3DMax 補(bǔ)片使手術(shù)操作更加簡(jiǎn)便。

引用本文： 祿韶英,佘軍軍,祁光裕,孫學(xué)軍. 腹腔鏡下應(yīng)用3DMax補(bǔ)片行腹股溝疝修補(bǔ)術(shù)（附18例報(bào)道）. 中國(guó)普外基礎(chǔ)與臨床雜志, 2010, 17(9): 974-975. doi: 復(fù)制

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  1. 1. Read RC. Herniology: past, present, and future [J]. Hernia, 2009; 13(6): 577580.
  2. 2. Eklund A, Carlsson P, Rosenblad A, et al. Longterm costminimization analysis comparing laparoscopic with open (Lichtenstein) inguinal hernia repair [J]. Br J Surg, 2010 Feb 24. DOI: 10.1002/bjs.6945.
  3. 3. 陳杰. 實(shí)用疝外科手術(shù)技巧 [M]. 北京： 北京科學(xué)技術(shù)出版社， 2008: 79.
  4. 4. Zacharoulis D, Fafoulakis F, Baloyiannis I, et al. Laparoscopic transabdominal preperitoneal repair of inguinal hernia under spinal anesthesia: a pilot study [J]. Am J Surg, 2009; 198(3): 456459.
  5. 5. Smink DS, Paquette IM, Finlayson SR. Utilization of laparoscopic and open inguinal hernia repair: a populationbased analysis [J]. J Laparoendosc Adv Surg Tech A, 2009; 19(6): 745748.
  6. 6. Zhang H, Lin J, Liao Q, et al. Totally extraperitoneal laparoscopic hernioplasty: the optimal surgical approach [J]. Surg Laparosc Endosc Percutan Tech, 2009; 19(6): 501505.
  7. 7. Evans MD, Williams GL, Stephenson BM. Low recurrence rate after laparoscopic (TEP) and open (Lichtenstein) inguinal hernia repair: a randomized, multicenter trial with 5year followup [J]. Ann Surg, 2009; 250(2): 354355.
  8. 8. Maddern G, Karatassas A, Hensman C. Pain or gain: new innovations and trends in hernia repair [J]. ANZ J Surg, 2009; 79(11): 778780.
  9. 9. Van Nieuwenhove Y, Vansteenkiste F, Vierendeels T, et al. Open, preperitoneal hernia repair with the Kugel patch: a prospective, multicentre study of 450 repairs [J]. Hernia, 2007; 11(1): 913.
  10. 10. Kurihara Y, Yamakawa T, Yoshino M, et al. Experience with direct Kugel patch method for repair of adult inguinal hernia [J]. J Nippon Med Sch, 2008; 75(1): 2831.
  11. 11. 向國(guó)安， 陳開運(yùn), 王漢寧, 等. 完全腹膜化腹腔鏡腹腔內(nèi)置片法與經(jīng)腹腔腹膜前網(wǎng)片法治療腹股溝疝比較 [J]. 中國(guó)普外基礎(chǔ)與臨床雜志, 2007; 14(5): 521523.
  12. 12. Dulucq JL, Wintringer P, Mahajna A. Laparoscopic totally extraperitoneal inguinal hernia repair: lessons learned from 3 100 hernia repairs over 15 years [J]. Surg Endosc, 2009; 23(3): 482486.
  13. 13. Mirilas P, Colborn GL, McClusky DA 3rd, et al. The history of anatomy and surgery of the preperitoneal space [J]. Arch Surg, 2005; 140(1): 9094.
  14. 14. 雷文章, 黃建朋. 腹膜前間隙無張力修補(bǔ)馬鞍疝的體會(huì) [J]. 中國(guó)普外基礎(chǔ)與臨床雜志, 2009; 16(2): 9294.
  15. 15. 朱紹輝, 王建國(guó). 巴德3DMax補(bǔ)片完全腹膜外腹腔鏡疝修補(bǔ)術(shù)21例報(bào)告 [J]. 中華疝和腹壁外科雜志(電子版), 2009; 3(3): 271274.