背景:为了研究可行性,右侧入路在腹腔镜经腹腹膜前两侧腹股沟疝修补术中的安全性和有效性。
方法:回顾性分析2015年1月至2020年9月陕西省人民医院普外科Ⅰ区189例术前或术中诊断为双侧腹股沟疝并行选择性TAPP的患者。94例采用右侧入路(研究组),95例采用常规方法(对照组)。观察比较两组患者术中、术后情况。
结果:所有手术均顺利完成。研究组手术时间明显短于对照组(128.8±35.4vs144.1±40.9min,P=0.006)。术后住院时间无显著差异,术后第一天VAS评分,血清和血肿的发生率,尿潴留等并发症(P>0.05)。所有患者均未出现疝气复发,网状感染,肠梗阻等并发症。
结论:右侧入路进入Retzius间隙在双侧腹股沟疝TAPP手术中是安全可行的。与常规方法相比,缩短手术时间,具有一定的优势。
BACKGROUND: To investigate the feasibility, safety and efficacy of the right-side approach to enter Retzius space in laparoscopic transabdominal preperitoneal bilateral inguinal hernia repair.
METHODS: Retrospective analysis was performed on 189 patients who were diagnosed with bilateral inguinal hernia preoperatively or intraoperatively and underwent selective TAPP in the General Surgery I Section of Shaanxi Provincial People\'s Hospital from January 2015 to September 2020. 94 cases were performed using the right-side approach (research group), and 95 cases with conventional approach (control group). Intraoperative and postoperative conditions of the two groups were observed and compared.
RESULTS: All operation were completed successfully. The operative time of research group was significantly shorter than that of control group (128.8 ± 35.4 vs 144.1 ± 40.9 min, P = 0.006). There were no significant differences in postoperative hospital stay, VAS score on first postoperative day, incidence of seroma and hematoma, urinary retention and other complications (P > 0.05). None of the patients occured hernia recurrence, mesh infection, intestinal obstruction and other complications.
CONCLUSIONS: The right-side approach to enter Retzius space is safe and feasible in TAPP surgery of bilateral inguinal hernia. Compared with the conventional approach, it can shorten the operative time and has certain advantages.