中国实用外科杂志

中国实用外科杂志

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开放腹股沟疝修补术中精索游离术式探讨（附78例报告）

檀谊洪1，杜国能1，刘剑文1，肖玉根1，李    民1，徐礼笑子1，邱万寿2   

  1. 1南方医科大学附属南海医院普外三科，广东佛山528200；2中山大学附属第三医院普通外科，广东广州510630
  • 发布日期:2012-02-24

  • Published:2012-02-24

摘要：

目的    探讨在开放腹股沟疝修补手术中游离精索新术式的可行性。方法    2009年12月至2011年5月，南方医科大学附属南海医院普外三科在择期78例（双侧疝19例）Lichtenstein疝修补术中采用新术式游离精索（游离精索的解剖平面在提睾肌筋膜浅层与腹横筋膜之间），观察有无出血和神经损伤，记录所需时间，随访术后并发症。结果    78例手术中修补斜疝82侧，直疝17侧；游离精索的时间为4～11min，平均6.9min；无一例发生1mL以上的出血；游离过程中损伤髂腹股沟神经1例；术后切口脂肪液化3例，术后耻骨上区疼痛1例，随访3个月以上无慢性疼痛病例。结论    在开放腹股沟疝修补术中，采用新术式游离精索的方法简单可行。

关键词: 腹股沟疝, 无张力疝修补术, 精索, 提睾肌筋膜

Abstract:

Technique for mobilizing spermatic cord in open hernioplasty: a report of 78 patients         TAN Yi-hong*, DU Guo-neng, LIU Jian-wen，et al. *Department Ⅲ of General Surgery, Affiliated Nanhai Hospital of Southern Medical University, Foshan 528200, China
Corresponding author: QIU Wan-shou，E-mail: wsqiu-d@163.com
Abstract    Objective    To explore the security and feasibility of a new technique for mobilization of spermatic cord in hernioplasty for adult male. Methods    Between December 2009 and May 2011, a new method for mobilizing spermatic cord was used in elective Lichtenstein tension-free hernioplasty for 78 patients（19 patients with bilateral hernias）in the Department Ⅲ of General Surgery, Affiliated Nanhai Hospital of Southern Medical University. Blood loss, nerve injury and the time consuming for mobilizing spermatic cord were recorded. All the patients were followed up 3 months for post-operative complications. Results    Eighty-two cases of indirect hernia and 17 cases of direct hernia were repaired successfully in 78 patients. Spermatic mobilization was completed in 4-11 min with an average duration of 6.9 min. None of the patients had hemorrhage of more than 1 mL. One case of ilioinguinal nerve injury was suffered during the procedure. Three cases presented with postoperative fat liquefaction of the wound. Postoperative suprapubic region pain occurred in 1 case. No chronic pain was observed in the following 3 months. Conclusion    The new technique for spermatic cord mobilization in hernioplasty is simple and feasible, which deserved promotion in hernioplasty.

Key words: inguinal hernia, tension-free hernioplasty, spermatic cord, cremasteric fascia