腹腔镜下完全腹膜外补片植入术(TEP)治疗腹股沟疝的手术技巧
腹腔镜；疝,腹股沟；完全腹膜外补片植入术,,腹腔镜；疝，腹股沟；完全腹膜外补片植入术,2结果,3讨论,参考文献：
【摘要】 目的：探讨腹腔镜下完全腹膜外补片植入术(TEP)治疗腹股沟疝的手术技巧。方法：对2004年4月至2006年8月我院实施TEP的269例(294例次)腹股沟疝患者的临床资料进行回顾性分析，并对手术技巧进行总结。结果：手术均获成功，未中转其他术式，平均手术时间(63.1±37.5)min,住院时间(3.7±1.4)d,恢复天数(7.3±1.6)d;术中出血量(12.3±8.2)ml，腹膜撕裂发生率为8.16%(24/294);术后皮下气肿发生率为3.07%(9/294),腹股沟血清肿发生率为2.38%(7/294)，出现异物感发生率0.68%(2/294)，术后未出现持续性神经性疼痛、切口感染及补片感染；术后随访1~29个月，3例出现复发，复发率为1.02%(3/294)。结论：熟练掌握腹股沟镜下解剖，运用合理的手术技巧和规范的操作，可以有效缩短学习曲线，减少手术时间，降低术中、术后并发症的发生。【关键词】 腹腔镜；疝，腹股沟；完全腹膜外补片植入术
The surgical skill of laparoscopic total extraperitoneal repair for inguinal herniorrhaphy
RONG Zhenxiang,LU Guangsheng,CHEN Xiaowu,et al.
Dept.of Gastroenterologic,Pancreatic and Hernia Surgery,the First Hospital of Shunde,Foshan 528300,China
【Abstract】 Objective:To explore the surgical skill of TEP.Methods:The clinical data of 269 patients (294 cases)undergoing TEP from April 2004 to August 2006 were analyzed retrospectively and the surgical skill was summarized.Results:All 294 cases of TEP were performed successfully with no transtered operation.The operation time means were(63.1±37.5)min(3.7±1.4d)(being in hospital time),(7.3±1.6)d(recovery time),and (12.3±8.2)ml(bleeding volum),respectively.The rates of peritoneum laceration,subcutancous emphysema after operation,inguinal hematoma and foreign body sensation,were 8.16%(24/294),3.07%(9/292),2.38%(7/294)and 0.68%(2/294),respectively.There were no complications of persistent nervous pain,incisional infection and onlay meshs infection after operation.The recurrence rate was 1.02%(3/294),with following up after operation(1~29months).Conclusions:The learning curve could be shorten,operation time be decreased and the rate of complications during or after operation be lowered through skilled laparoscopic anatomy,appropriate usage of surgical skill and standard operation. ......
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