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中华疝和腹壁外科杂志(电子版) ›› 2019, Vol. 13 ›› Issue (02) : 126 -129. doi: 10.3877/cma.j.issn.1674-392X.2019.02.007

所属专题: 文献

论著

腹横肌后平片腹股沟疝修补法的初步研究
唐黎明1,(), 孙一峰1, 徐妙军1, 费晓舟1, 林志强1, 刘春江1   
  1. 1. 312000 绍兴市人民医院血管疝外科
  • 收稿日期:2018-08-19 出版日期:2019-04-18
  • 通信作者: 唐黎明

Preliminary outcomes of inguinal hernia repair with posterior transverse abdominis mesh placement

Liming Tang1,(), Yifeng Sun1, Miaojun Xu1, Xiaozhou Fei1, Zhiqiang Lin1, Cunjiang Liu1   

  1. 1. Department of Hernia and Abdominal Surgery, Shaoxing People's Hospital, Shaoxing 312000, China
  • Received:2018-08-19 Published:2019-04-18
  • Corresponding author: Liming Tang
  • About author:
    Corresponding author: Tang Liming, Email:
引用本文:

唐黎明, 孙一峰, 徐妙军, 费晓舟, 林志强, 刘春江. 腹横肌后平片腹股沟疝修补法的初步研究[J]. 中华疝和腹壁外科杂志(电子版), 2019, 13(02): 126-129.

Liming Tang, Yifeng Sun, Miaojun Xu, Xiaozhou Fei, Zhiqiang Lin, Cunjiang Liu. Preliminary outcomes of inguinal hernia repair with posterior transverse abdominis mesh placement[J]. Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition), 2019, 13(02): 126-129.

目的

初步评估腹横肌后平片腹股沟疝修补术的安全性和有效性。

方法

筛选绍兴市人民医院2018年1至6月,30例原发性单侧腹股沟疝患者进行预试验。手术中完成疝囊高位游离并回纳至腹膜前间隙,缩小内环口,分离腹横筋膜和腹横肌之间间隙,将原Lichtenstein腹股沟疝修补术中放置于腹外斜肌腱膜后的补片向后移位,放置于腹横肌后,固定。观察手术时间、术中出血、术后疼痛、住院时间及复发率。

结果

30例全部顺利完成手术,平均手术(46.6±7.1)min,术中出血量(12.5±5.0)mL,术后疼痛视觉模拟评分(2.8±0.9)分,术后无其他并发症发生,平均住院时间(3.4±1.0)d。术后随访平均(2.5±1.2)个月,未见复发。

结论

初步的预试验证明全腹横肌后平片腹股沟疝修补术是安全有效的,但由于观察人群特殊、样本数小,随访时间短,还有待于进一步研究。

Objectives

To evaluate the safety and efficacy of the inguinal hernia repair with posterior transverse abdominis mesh placement.

Methods

From January to June 2018, 30 patients with primary unilateral inguinal hernia from Shaoxing People's Hospital were selected for the test. In the beginning, the procedure of the operation was same as the Lichtenstein's inguinal hernia repair such as the hernia sac was freed and returned to the preperitoneal space, the inner ring was narrowed. The next part was different, the space between the transverse fascia and the transverse abdominis muscle was separated by the operator's finger, the mesh was shaped to fit the space, and the upper and inner parts of the mesh were placed under the transverse abdominis muscle and fixed. The data of the operation time, amount of bleeding, postoperative pain, length of hospital stay, and recurrence rate were observed.

Results

All of the 30 patients were successfully completed the operation, the average operation was (46.6±7.1) minutes, the amount of bleeding intraoperation was (12.5±5.0) mL, and the VAS score of postoperative pain was (2.8±0.9) scors. No other complications were observed after operation. The average hospitalization day was (3.4±1.0) days. The mean follow-up was (2.5±1.2) months, and no recurrence occurred.

Conclusion

Preliminary tests have shown that the inguinal hernia repair with posterior transverse abdominis mesh placement is safe and effective, and the test remains to be further studied.

图1 11.0 cm×6.5 cm的矩形补片,经裁剪后的形状
图2 白色硅胶管牵拉的为精索,红色橡皮条牵拉的精索血管和黄色橡皮条牵拉的输精管从预裁孔穿过,蓝色橡皮条牵拉的是提睾肌。
图3 补片内侧部和上部置于腹横肌后
图4 箭头所指:补片内下方固定于外环内侧脚
图5 箭头所指:切开的腹横肌腱膜,是否会使腹股沟管后壁更加薄弱?
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