开放式后入路腹膜前腹股沟疝网片修补术的临床应用及体会

摘要

Objective:To evaluate the effect of hernioplasty for inguinal hernia through open posterior approach by using monolayer mesh patch. Methods:Data of 272 cases with inguinal hernia who underwent hemioplasty through open posterior approach by using monolayer mesh patch from July 2006 to July 2012 were analyzed retrospectively.Results:The average operative time was 35 mins.The mean time of postoperative hospitalization was 5.5 days. According to 2-60 months following up,4 cases with scrotum hematoma were cured by sucking up,1 case with cutting edge hematoma was cured by cutting open.We found no infection with the cutting edge and the patch.We observed no chronic pain,no testicle atrophy,no pain when giving sperm.No recurrence occurred.Conclusion:It is safe and effective to use hernioplasty for inguinal hernia through open posterior approach by using monolayer mesh patch.Being familiar with the anatomy, understanding the concept of viscera bag,entering the preperitoneal gap precisely,choosing and placing the patch correctly,mastering the study curve,are crucial for operating success.%　　目的：探讨开放式后入路腹膜前腹股沟疝网片修补术的手术方法及临床疗效。方法：回顾性分析2006年7月-2012年7月笔者所在医院行开放式后入路腹膜前腹股沟疝网片修补术272例患者的临床资料。结果：手术时间25~65 min，平均35 min，术后住院时间5~9 d，平均5.5 d。术后随访2~60个月，术后4例出现阴囊血肿经抽吸后治愈，1例出现切口血肿经切排后治愈，无切口及补片感染，无慢性疼痛、睾丸萎缩、射精痛等并发症发生，无疝复发。结论：开放式后入路腹膜前腹股沟疝网片修补术是一种安全、疗效好的手术方式。熟悉耻骨肌孔的解剖结构、领会内脏囊概念，准确进入腹膜前间隙，正确的选择和放置网片，科学合理地掌握学习曲线，是保证手术成功的关键。