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中华疝和腹壁外科杂志(电子版) ›› 2022, Vol. 16 ›› Issue (05) : 525 -530. doi: 10.3877/cma.j.issn.1674-392X.2022.05.008

临床论著

生物补片应用于腹腔镜全腹膜外成人腹股沟疝修补的疗效分析
吴明东1, 刘俊杰1, 喻武1, 张明逸1, 周好男1, 冉坤1, 孙建明1, 唐博1, 陈以宽1,()   
  1. 1. 400010 重庆医科大学附属第二医院血管疝腹壁外科
  • 收稿日期:2022-06-09 出版日期:2022-10-18
  • 通信作者: 陈以宽
  • 基金资助:
    吴阶平医学基金会卓越外科专项基金资助项目(320.6750.19091-13)

Clinical analysis of biological mesh applied in laparoscopic total extraperitoneal inguinal hernia repair in adults

Mingdong Wu1, Junjie Liu1, Wu Yu1, Mingyi Zhang1, Haonan Zhou1, Kun Ran1, Jianming Sun1, Bo Tang1, Yikuan Chen1,()   

  1. 1. Department of Vascular Hernia Abdominal Wall Surgery, the Second Affiliated Hospital of Chongqing Medical University, Chongqing 400010, China
  • Received:2022-06-09 Published:2022-10-18
  • Corresponding author: Yikuan Chen
引用本文:

吴明东, 刘俊杰, 喻武, 张明逸, 周好男, 冉坤, 孙建明, 唐博, 陈以宽. 生物补片应用于腹腔镜全腹膜外成人腹股沟疝修补的疗效分析[J/OL]. 中华疝和腹壁外科杂志(电子版), 2022, 16(05): 525-530.

Mingdong Wu, Junjie Liu, Wu Yu, Mingyi Zhang, Haonan Zhou, Kun Ran, Jianming Sun, Bo Tang, Yikuan Chen. Clinical analysis of biological mesh applied in laparoscopic total extraperitoneal inguinal hernia repair in adults[J/OL]. Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition), 2022, 16(05): 525-530.

目的

探讨生物补片应用于成人腹股沟疝腹腔镜全腹膜外修补术(TEP)的早期临床安全性和有效性。

方法

回顾性分析2020年5月至2022年1月在重庆医科大学附属第二医院接受生物补片TEP修补术的75例腹股沟疝患者的临床和随访资料,观察术后复发、早期反应和并发症情况。

结果

纳入腹股沟疝患者75例(102侧)。均顺利完成手术,无中转开腹情况。单侧腹股沟疝平均手术时间为(59.0±9.2)min,双侧平均手术时间为(86.4±15.0)min。术后中等度热6例(8.0%),血清肿11例(13侧,12.7%),中度及以上急性疼痛16例(18侧,17.6%)。平均随访时间(9.7±5.7)个月,疝复发3例(2.9%),慢性疼痛1例(1.3%)。

结论

应用生物补片行TEP修补术安全有效。生物补片的术后早期反应主要为发热、血清肿和疼痛,妥善缝合固定补片可减少术后复发。

Objective

To investigate the early clinical safety and efficacy of biological mesh in laparoscopic total extraperitoneal repair (TEP) for adult inguinal hernia.

Methods

The clinical and follow-up data of 75 patients with inguinal hernia who underwent TEP repair with biological mesh in the Second Affiliated Hospital of Chongqing Medical University from May 2020 to January 2022 were retrospectively analyzed. The postoperative recurrence, early reactions and complications were recorded.

Results

75 patients (102 sides) with inguinal hernias were included. All operations were performed successfully and none was converted to open surgery. The average operation time for the unilateral hernia was (59.0±9.2) min, and the average operation time for the bilateral hernia was (86.4±15.0) min. 6 patients (8.0%) had postoperative moderate fever. 16 patients (18 sides, 17.6%) had moderate to severe acute pain. 11 patients (13 sides, 12.7%) had seroma. The average follow-up time was (9.7±5.7) months . The hernia recurrence occurred in 3 cases (2.9%).1 patient (1.3%) had chronic pain.

Conclusion

The application of biological mesh for TEP repair is safe and effective. The early postoperative complications of biological mesh are mainly fever, seroma, and pain. Proper suture and fixation of the mesh can reduce the recurrence.

图1 左侧腹股沟直疝腹腔镜全腹膜外疝修补术注:1A间隙游离后主要解剖标志,箭头所指为直疝缺损;1B不吸收倒刺线连续缝合直疝缺损;1C直疝缺损被缝合关闭;1D于髂前上棘(黄色箭头)、Cooper韧带(红色箭头)缝合固定补片
表1 75例患者一般临床资料
表2 75例患者术后不同时间腹股沟区疼痛数字量表评分[侧(%)]
表3 75例患者术后早期反应
表4 术后早期反应的多因素Logistic回归分析
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