中国实用外科杂志

中国实用外科杂志 ›› 2023, Vol. 43 ›› Issue (10): 1176-1179.DOI: 10.19538/j.cjps.issn1005-2208.2023.10.22

• 论著 • 上一篇    下一篇

套管分离法用于全腹膜外腹股沟疝修补术124例临床分析

马少卫，郑    宇，李卫泊，武华栋，宋春义，张祥宇，赵烁玺，王    佳，周保军   

  1. 河北医科大学第二医院胃肠外科、疝与腹壁外科，河北石家庄 050000
  • 出版日期:2023-10-01 发布日期:2023-10-24

  • Online:2023-10-01 Published:2023-10-24

摘要： 目的    探讨套管分离法在腹腔镜全腹膜外腹股沟疝修补术（TEP）中应用的安全性和有效性。方法  回顾性分析2020年3—9月河北医科大学第二医院胃肠、疝与腹壁外科收治的124例行TEP病人的临床资料，术中均采用套管分离法建立腹膜前间隙，其中单侧疝84例，双侧疝40例。术后随访观察疗效。结果    所有病人均顺利建立腹膜前间隙，无腹膜破裂，均成功完成TEP。单侧腹膜前间隙建立时间为（13.6±1.8）min，双侧为（18.5±2.3）min；术中单侧出血为（2.2±0.7）mL，双侧为（2.6±1.1）mL。术后发生阴囊气肿3例，保守治疗后好转。随访26（23~29）个月，未见复发和手术区慢性疼痛等并发症发生。结论    TEP中采用套管分离法建立腹膜前间隙安全、可行，有助于认识腹膜前间隙的解剖，降低TEP技术难度。

关键词: 腹股沟疝, 全腹膜外腹股沟疝修补术, 腹膜前间隙, 套管分离法

Abstract: Clinical analysis of 124 cases of total extraperitoneal hernia repair with cannula separation        MA Shao-wei, ZHENG Yu, LI Wei-bo, et al. Department of Gastrointestinal Surgery, Hernia and Abdominal Wall Surgery, the Second Hospital of Hebei Medical University, Shijiazhuang 050000, China 
Corresponding author: ZHOU Bao-jun, E-mail: zhoubaojun67@163.com
Abstract    Objective    To explore the safety and practicability of cannula separation in laparoscopic total extraperitoneal hernia repair(TEP). Methods    From March 2020 to September 2020, 124 patients with inguinal hernia received TEP by using the cannula separation method to establish the preperitoneal space, including 84 cases of unilateral inguinal hernia and 40 cases of bilateral inguinal hernia. Results    All patients successfully established the preperitoneal space and successfully performed TEP. The establishment time of the preperitoneal space of the single side was (13.6±1.8)minutes, and that of the double sides was(18.5±2.3)minutes. There was no peritoneal injury. The intraoperative bleeding was(2.2±0.7)mL on the single side and(2.6±1.1)mL on the double sides. Postoperative scrotum pneumatosis was found in 3 cases that could be absorbed by using conservative treatment. All patients were followed up until August 2022, and the median follow-up time was 26(23-29)months. There was no recurrence or chronic pain in the operation area.  Conclusion    Establishing the preperitoneal space by cannula separation in TEP is safe, and feasible, which can help beginners have a clearer understanding of the anatomy of the preperitoneal space, thereby reducing the technical threshold of TEP surgery.

Key words: inguinal hernia, total extraperitoneal hernia repair（TEP）, preperitoneal space, cannula separation