• 首都醫(yī)科大學(xué)附屬北京朝陽醫(yī)院疝和腹壁外科(北京 100020);

目的  探討腹腔鏡經(jīng)腹腹膜前(TAPP)疝修補(bǔ)術(shù)治療腹股溝復(fù)發(fā)疝的手術(shù)技巧及臨床效果。
方法  回顧性分析2009年3月至2012年12月期間首都醫(yī)科大學(xué)附屬北京朝陽醫(yī)院行腹腔鏡TAPP疝修補(bǔ)術(shù)治療的130例腹股溝復(fù)發(fā)疝患者的臨床資料。
結(jié)果  129例患者的腹腔鏡TAPP疝修補(bǔ)術(shù)順利完成,1例中轉(zhuǎn)開放手術(shù)。手術(shù)時(shí)間為(54.5±16.1) min (30~100min),住院時(shí)間為(4.5±2.1) d (2~11d)。術(shù)后疼痛發(fā)生率為3.8% (5/130),陰囊腫脹積液發(fā)生率為11.5% (15/130),排尿困難發(fā)生率為1.5% (2/130),無體內(nèi)異物感、切口感染、腸梗阻等其他并發(fā)癥發(fā)生。術(shù)后130例患者均獲訪,隨訪時(shí)間為7~50個(gè)月、(24.3±11.3)個(gè)月,無復(fù)發(fā)。
結(jié)論  對(duì)于腹股溝復(fù)發(fā)疝的治療,腹腔鏡TAPP疝修補(bǔ)術(shù)具有創(chuàng)傷小、并發(fā)癥少等優(yōu)勢(shì),且其手術(shù)安全性高,效果切實(shí)可靠。

引用本文: 趙學(xué)飛,聶玉勝,劉靜,王明剛,陳杰. 腹腔鏡TAPP技術(shù)在治療腹股溝復(fù)發(fā)疝中的應(yīng)用. 中國普外基礎(chǔ)與臨床雜志, 2013, 20(12): 1344-1348. doi: 復(fù)制

1. 趙學(xué)飛, 申英末, 陳杰, 等. 腹股溝疝無張力修補(bǔ)術(shù)中補(bǔ)片固定方式的演變與進(jìn)展[J]. 中華疝和腹壁外科雜志:電子版, 2012, 6(3):817-821.
2. Lichtenstein IL, Shulman AG, Amid PK, et al. The tension-free hernioplasty[J]. Am J Surg, 1989, 157(2):188-193.
3. Memon AA, Siddiqui FG, Abro AH, et al. Management of recurrent inguinal hernia at a tertiary care hospital of southern Sindh, Pakistan[J]. World J Surg, 2013, 37(3):510-515.
4. Bisgaard T, Bay-Nielsen M, Kehlet H. Re-recurrence after operation for recurrent inguinal hernia. A nationwide 8-year follow-up study on the role of type of repair[J]. Ann Surg, 2008, 247(4):707-711.
5. Bay-Nielsen M, Kehlet H, Strand L, et al. Quality assessment of 26 304 herniorrhaphies in Denmark:a prospective nationwide study[J]. Lancet, 2001, 358(9288):1124-1128.
6. Haapaniemi S, Gunnarsson U, Nordin P, et al. Reoperation after recurrent groin hernia repair[J]. Ann Surg, 2001, 234(1):122-126.
7. Dedemadi G, Sgourakis G, Radtke A, et al. Laparoscopic versus open mesh repair for recurrent inguinal hernia:a meta-analysis of outcomes[J]. Am J Surg, 2010, 200(2):291-297.
8. 中華醫(yī)學(xué)會(huì)外科學(xué)分會(huì)疝和腹壁外科學(xué)組. 成人腹股溝疝診療指南[J]. 中國實(shí)用外科雜志, 2012, 32(10):833-835.
9. Valenti G, Baldassarre E, Testa A, et al. Dynamic self-regulating prosthesis (protesi autoregolantesi dinamica):the long-term resultsin the treatment of primary inguinal hernias[J]. Am Surg, 2006, 72(3):244-248.
10. Ruhl CE, Everhart JE. Risk factors for inguinal hernia among adults in the US population[J]. Am J Epidemiol, 2007, 165(10):1154-1161.
11. Junge K, Rosch R, Klinge U, et al. Risk factors related to recurr-ence in inguinal hernia repair:a retrospective analysis[J]. Hernia,2006, 10(4):309-315.
12. 楊斌, 賴東明, 江志鵬, 等. 無張力修補(bǔ)術(shù)后腹股溝復(fù)發(fā)疝再手術(shù)的探討[J]. 中華疝和腹壁外科雜志:電子版, 2010, 4(4):364-367.
13. Nordin P, van der Linden W. Volume of procedures and risk of recurrence after repair of groin hernia:national register study[J]. BMJ, 2008, 336(7650):934-937.
14. 張?jiān)疲?王映昌, 李健文, 等. 腹腔鏡腹股溝疝修補(bǔ)術(shù)后復(fù)發(fā)的原因及再手術(shù)治療[J]. 上海醫(yī)學(xué), 2011, 34(11):869-872.
15. 唐健雄. 無張力疝修補(bǔ)手術(shù)后復(fù)發(fā)與手術(shù)者的相關(guān)因素[J]. 臨床外科雜志, 2006, 14(11):686-687.
16. 任為, 時(shí)德. 運(yùn)用Cox比例風(fēng)險(xiǎn)回歸模型分析腹股溝疝復(fù)發(fā)的危險(xiǎn)因素[J]. 中國普外基礎(chǔ)與臨床雜志, 2003, 10(3):263-265.
17. 唐健雄. 腹股溝復(fù)發(fā)疝的手術(shù)治療[J]. 中國普外基礎(chǔ)與臨床雜志, 2003, 10(1):4-5.
18. Phillips EH, Rosenthal R, Fallas M, et al. Reasons for earlyrecurrence following laparoscopic hernioplasty[J]. Surg Endosc,1995, 9(2):140-144.
19. Ger R. Laparoscopic hernia operation[J]. Chirurg, 1991, 62(4):266-270.
20. Cavazzola LT, Rosen MJ. Laparoscopic versus open inguinal herniarepair[J]. Surg Clin North Am, 2013, 93(5):1269-1279.
21. Feliu X, Jaurrieta E, Viñas X, et al. Recurrent inguinal hernia:a ten-year review[J]. J Laparoendosc Adv Surg Tech A, 2004, 14(6):362-367.
22. Dedemadi G, Sgourakis G, Karaliotas C, et al. Comparison of laparoscopic and open tension-free repair of recurrent inguinal hernias:a prospective randomized study[J]. Surg Endosc, 2006, 20(7):1099-1104.
23. Gholghesaei M, Langeveld HR, Veldkamp R, et al. Costs and quality of life after endoscopic repair of inguinal hernia vs. open tension-free repair:a review[J]. Surg Endosc, 2005, 19(6):816-821.
24. Pironi D, Palazzini G, Panarese A, et al. Open mesh technique versus laparoscopic transabdominal preperitoneal (TAPP) approachin inguinal hernia repair. Our experience[J]. G Chir, 2008, 29(11-12):497-504.
25. 李健文, 王映昌, 張凌捷, 等. 腹股溝疝腹腔鏡手術(shù)在我國逐步推廣的可行性探討[J]. 外科理論與實(shí)踐, 2010, 15(6):611-615.
26. Taylor C, Layani L, Liew V, et al. Laparoscopic inguinal hernia repair without mesh fixation, early results of a large randomised clinical trial[J]. Surg Endosc, 2008, 22(3):757-762.
  1. 1. 趙學(xué)飛, 申英末, 陳杰, 等. 腹股溝疝無張力修補(bǔ)術(shù)中補(bǔ)片固定方式的演變與進(jìn)展[J]. 中華疝和腹壁外科雜志:電子版, 2012, 6(3):817-821.
  2. 2. Lichtenstein IL, Shulman AG, Amid PK, et al. The tension-free hernioplasty[J]. Am J Surg, 1989, 157(2):188-193.
  3. 3. Memon AA, Siddiqui FG, Abro AH, et al. Management of recurrent inguinal hernia at a tertiary care hospital of southern Sindh, Pakistan[J]. World J Surg, 2013, 37(3):510-515.
  4. 4. Bisgaard T, Bay-Nielsen M, Kehlet H. Re-recurrence after operation for recurrent inguinal hernia. A nationwide 8-year follow-up study on the role of type of repair[J]. Ann Surg, 2008, 247(4):707-711.
  5. 5. Bay-Nielsen M, Kehlet H, Strand L, et al. Quality assessment of 26 304 herniorrhaphies in Denmark:a prospective nationwide study[J]. Lancet, 2001, 358(9288):1124-1128.
  6. 6. Haapaniemi S, Gunnarsson U, Nordin P, et al. Reoperation after recurrent groin hernia repair[J]. Ann Surg, 2001, 234(1):122-126.
  7. 7. Dedemadi G, Sgourakis G, Radtke A, et al. Laparoscopic versus open mesh repair for recurrent inguinal hernia:a meta-analysis of outcomes[J]. Am J Surg, 2010, 200(2):291-297.
  8. 8. 中華醫(yī)學(xué)會(huì)外科學(xué)分會(huì)疝和腹壁外科學(xué)組. 成人腹股溝疝診療指南[J]. 中國實(shí)用外科雜志, 2012, 32(10):833-835.
  9. 9. Valenti G, Baldassarre E, Testa A, et al. Dynamic self-regulating prosthesis (protesi autoregolantesi dinamica):the long-term resultsin the treatment of primary inguinal hernias[J]. Am Surg, 2006, 72(3):244-248.
  10. 10. Ruhl CE, Everhart JE. Risk factors for inguinal hernia among adults in the US population[J]. Am J Epidemiol, 2007, 165(10):1154-1161.
  11. 11. Junge K, Rosch R, Klinge U, et al. Risk factors related to recurr-ence in inguinal hernia repair:a retrospective analysis[J]. Hernia,2006, 10(4):309-315.
  12. 12. 楊斌, 賴東明, 江志鵬, 等. 無張力修補(bǔ)術(shù)后腹股溝復(fù)發(fā)疝再手術(shù)的探討[J]. 中華疝和腹壁外科雜志:電子版, 2010, 4(4):364-367.
  13. 13. Nordin P, van der Linden W. Volume of procedures and risk of recurrence after repair of groin hernia:national register study[J]. BMJ, 2008, 336(7650):934-937.
  14. 14. 張?jiān)疲?王映昌, 李健文, 等. 腹腔鏡腹股溝疝修補(bǔ)術(shù)后復(fù)發(fā)的原因及再手術(shù)治療[J]. 上海醫(yī)學(xué), 2011, 34(11):869-872.
  15. 15. 唐健雄. 無張力疝修補(bǔ)手術(shù)后復(fù)發(fā)與手術(shù)者的相關(guān)因素[J]. 臨床外科雜志, 2006, 14(11):686-687.
  16. 16. 任為, 時(shí)德. 運(yùn)用Cox比例風(fēng)險(xiǎn)回歸模型分析腹股溝疝復(fù)發(fā)的危險(xiǎn)因素[J]. 中國普外基礎(chǔ)與臨床雜志, 2003, 10(3):263-265.
  17. 17. 唐健雄. 腹股溝復(fù)發(fā)疝的手術(shù)治療[J]. 中國普外基礎(chǔ)與臨床雜志, 2003, 10(1):4-5.
  18. 18. Phillips EH, Rosenthal R, Fallas M, et al. Reasons for earlyrecurrence following laparoscopic hernioplasty[J]. Surg Endosc,1995, 9(2):140-144.
  19. 19. Ger R. Laparoscopic hernia operation[J]. Chirurg, 1991, 62(4):266-270.
  20. 20. Cavazzola LT, Rosen MJ. Laparoscopic versus open inguinal herniarepair[J]. Surg Clin North Am, 2013, 93(5):1269-1279.
  21. 21. Feliu X, Jaurrieta E, Viñas X, et al. Recurrent inguinal hernia:a ten-year review[J]. J Laparoendosc Adv Surg Tech A, 2004, 14(6):362-367.
  22. 22. Dedemadi G, Sgourakis G, Karaliotas C, et al. Comparison of laparoscopic and open tension-free repair of recurrent inguinal hernias:a prospective randomized study[J]. Surg Endosc, 2006, 20(7):1099-1104.
  23. 23. Gholghesaei M, Langeveld HR, Veldkamp R, et al. Costs and quality of life after endoscopic repair of inguinal hernia vs. open tension-free repair:a review[J]. Surg Endosc, 2005, 19(6):816-821.
  24. 24. Pironi D, Palazzini G, Panarese A, et al. Open mesh technique versus laparoscopic transabdominal preperitoneal (TAPP) approachin inguinal hernia repair. Our experience[J]. G Chir, 2008, 29(11-12):497-504.
  25. 25. 李健文, 王映昌, 張凌捷, 等. 腹股溝疝腹腔鏡手術(shù)在我國逐步推廣的可行性探討[J]. 外科理論與實(shí)踐, 2010, 15(6):611-615.
  26. 26. Taylor C, Layani L, Liew V, et al. Laparoscopic inguinal hernia repair without mesh fixation, early results of a large randomised clinical trial[J]. Surg Endosc, 2008, 22(3):757-762.